Management of Acute Laryngeal Trauma Patients

Background and Objectives:Laryngeal trauma is an uncommon but potentially catastrophic injury. The purpose of this study was to analyze the association between injury mechanism and the degree of injury, and to assess the outcome after the treatment. Materials and Method:A 10-year retrospective study of 21 patients with acute laryngeal trauma seen from 1988 to 1997 at Wonju Christian Hospital is presented. All patients are classified by injury mechanism (penetrating vs blunt and degree of injury (Group Ⅰ through Ⅴ. These patients have been studied with attention to clinical manifestation, injury mechanism, degree of injury and outcome after the treatment. Results:The main presenting symptoms and signs were dyspnea, hoarseness, tenderness and subcutaneous emphysema. Eleven cases were categorized as penetrating injury and the other ten cases as blu- nt injury. Sites of laryngeal injury included thyroid cartilage fracture, soft tissue laceration, cricoid cartilage fracture, pyriform sinus perforation and vocal folds injury. All patients were decannulated. Sixteen patients made a full return to normal voice, four were assessed fair but one was graded as poor. Conclusion:Conservative treatment of group Ⅱ injuries was effective. In this cases, the greater the actual trauma, the poorer the results. Also, blunt trauma proved more serious than penetrating trauma and early surgical intervention was associated with better outcome. Authors suggest esophagoscopy to be performed at the time of operation. (Korean J Otolaryngol 1998;41(11 :1459-1463 KEY WORD:Laryngeal trauma.