Laryngeal fractures due to blunt trauma

INTRODUCTION: Laryngeal fractures due to blunt trauma are rare. Consensus on diagnosis and treatment is therefore needed. MATERIALS AND METHODS: A retrospective search of patient records in the period 2000-2007. Data were obtained on sex, age, time from trauma to first medical visit, time from trauma to operation, result of laryngeal computertomography, pre- and postoperative videostroboscopy, pre- and postoperative evaluation of voice quality, method of operation and status at last follow-up. RESULTS: Seven patients, six males aged 24-54 and one female aged 24. All had moderate to severe laryngeal trauma, and all except one needed surgical intervention. Three had the fracture stabilized with titanium net/miniplates. The postoperative voice was evaluated as good/acceptable in four patients, one had a recurrent nerve palsy and was lost to follow-up; one is still undergoing voice therapy. CONCLUSION: Patients must be examined for hoarseness, laryngeal pain, aphonia, asymmetry, bleeding and subcutaneous emphysema located in or around the larynx. Based on a computertomography, dislocated fractures should be operated (preferably within 48 hours). It is necessary to obtain stable fractures. The use of titanium nets or miniplates is recommended.