TY - JOUR
T1 - Extrinsic civilian trauma to the larynx and cervical trachea—important predictors of long-term morbidity
AU - Angood, P. B.
AU - Attia, E. L.
AU - Brown, R. A.
AU - Mulder, D. S.
PY - 1986/10
Y1 - 1986/10
N2 - Injuries to the larynx and cervical trachea are uncommon, making the development of treatment protocols and subsequent data analysis in any one hospital difficult. This prompted a review of our experience with emphasis on variables related to long-term morbidity. The records of 20 patients with laryngotracheal injuries seen at the Montreal General Hospital from January 1974 to December 1984 were reviewed. The majority were young males (18 to 20 years old), and there was blunt trauma in 14 and penetrating trauma in six. The level of injury was laryngeal in 16 and tracheal in four. There were no airway-related deaths. One patient died with uncontrollable retroperitoneal hemorrhage before definitive repair of the tracheal transection. All but two of the remaining 19 patients had significant morbidity in the form of aphonia, dysphonia, or airway stenosis. The major factors contributing to the high morbidity were delay in diagnosis, anatomic level of injury, and associated multisystem trauma. A high index of suspicion, liberal use of fiberoptic bronchoscopy for diagnosis, and early airway control will lead to earlier diagnosis. Computerized tomography of the upper airway facilitates definitive surgical repair. Long-term followup is essential. Laryngeal trauma remains a major challenge.
AB - Injuries to the larynx and cervical trachea are uncommon, making the development of treatment protocols and subsequent data analysis in any one hospital difficult. This prompted a review of our experience with emphasis on variables related to long-term morbidity. The records of 20 patients with laryngotracheal injuries seen at the Montreal General Hospital from January 1974 to December 1984 were reviewed. The majority were young males (18 to 20 years old), and there was blunt trauma in 14 and penetrating trauma in six. The level of injury was laryngeal in 16 and tracheal in four. There were no airway-related deaths. One patient died with uncontrollable retroperitoneal hemorrhage before definitive repair of the tracheal transection. All but two of the remaining 19 patients had significant morbidity in the form of aphonia, dysphonia, or airway stenosis. The major factors contributing to the high morbidity were delay in diagnosis, anatomic level of injury, and associated multisystem trauma. A high index of suspicion, liberal use of fiberoptic bronchoscopy for diagnosis, and early airway control will lead to earlier diagnosis. Computerized tomography of the upper airway facilitates definitive surgical repair. Long-term followup is essential. Laryngeal trauma remains a major challenge.
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U2 - 10.1097/00005373-198610000-00002
DO - 10.1097/00005373-198610000-00002
M3 - Article
C2 - 3772995
AN - SCOPUS:0022977149
SN - 0022-5282
VL - 26
SP - 869
EP - 873
JO - Journal of Trauma and Acute Care Surgery
JF - Journal of Trauma and Acute Care Surgery
IS - 10
ER -