Clinical considerations for blunt laryngotracheal trauma in children

Cheng, Jeffrey; Cooper, Matthew; Tracy, Elisabeth T.

doi:10.1016/j.jpedsurg.2016.12.019

Cited by 17 publications

(11 citation statements)

References 47 publications

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“…Immediate tracheostomy in lieu of orotracheal intubation presents the most controlled method to establish an airway and is utilized in approximately 33% of cases. 6 Nevertheless, tracheostomy may not completely stabilize the airway, and the distal airway may be highly mobile in the case of complete mid-laryngeal disruption as demonstrated here.…”

Section: Discussionmentioning

confidence: 83%

“…1,2 Diagnosis and treatment should be timely, given the possibility of acute decompensation as well as the risks of associated long-term sequelae. 6 While management should include airway security prior to addressing swallow function and voice restoration, the latter should not be underappreciated. Patient and parent counseling should include a discussion of these goals and the expectations at each stage of treatment.…”

Section: Discussionmentioning

confidence: 99%

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Operative Management of Vocal Fold Avulsion Following Pediatric Laryngotracheal Separation

Chang

Schoppy

et al. 2019

Ear Nose Throat J

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Laryngotracheal disruption in children is rare but life-threatening, and endolaryngeal injuries may go overlooked. We present the case of a 10-year-old boy who sustained near-complete laryngotracheal separation, multiple laryngeal fractures, and arytenoid and vocal fold avulsion following blunt cervical trauma. These injuries were not identified radiographically and only became apparent intraoperatively. Following surgical repair, the patient was successfully decannulated, eating a normal diet, and had a serviceable speaking voice within 2 months. In children, the diagnosis of severe endolaryngeal injuries may be elusive and therefore require high degree of clinical suspicion. Surgical success requires accurate diagnosis and prompt intervention.

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Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Operative Management of Vocal Fold Avulsion Following Pediatric Laryngotracheal Separation

Chang

Schoppy

et al. 2019

Ear Nose Throat J

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“…Esetleg a trachealis légsáv elmosódása, megszakadása vagy paratrachealis légsáv jelenhet meg. Mindezek alapján a negatív CT nem zárja ki a légcsősérülés lehetőségét [9][10][11]. Segítségünkre lehet a háromdimenziós rekonstrukció vagy a virtuális bronchoszkópia is a diagnózisban.…”

Section: Esetismertetésunclassified

A túlfújt endotrachealis mandzsetta szerepe a légcsősérülések diagnosztikájában

et al. 2020

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Absztrakt: A tracheobronchialis sérülések ritkák, de életveszélyes állapotot jelenthetnek. Leggyakoribb okaik a nyaki vagy mellkasi, nagy energiájú tompa trauma, a nehéz intubálás vagy az intratrachealis tubus és gyomorszonda együttes viselése. A korai diagnózis és a megfelelő kezelés életmentő lehet, e sérülések felismerése azonban az atípusos tünetek és a súlyos társsérülések miatt gyakran elhúzódik. Típusos esetekben a fizikális vizsgálat során progresszív, kiterjedt subcutan emphysema hívhatja fel rájuk a figyelmet. További nehézséget jelent, hogy a radiológiai jelek nem elég specifikusak, a komputertomográfiás felvételeken pedig a leggyakrabban csupán subcutan emphysema, pneumomediastinum vagy esetenként pneumothorax látható. Cikkünkben három eset kapcsán mutatjuk be a tracheobronchialis sérüléseket – egy baleseti, egy nehéz intubációs légúti sérülés, illetve egy tracheooesophagealis fistula kialakulása során. Az endotrachealis tubus ballonja a tracheafal rupturája mentén mindegyik esetben túlfújhatóvá vált, így a légút falán kívülre terjedt – ez a képalkotó vizsgálatokon láthatóvá is vált. Ez egy ritka, de direkt és egyértelmű jele a légúti sérüléseknek, mely alapján a trachea teljes falvastagságának szakadására lehet számítani. Cikkünkben a túlfújt ballon diagnosztikus jelentőségére szeretnénk rávilágítani. Orv Hetil. 2020; 161(25): 1063–1068.

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“…Blunt trauma to the neck usually results from motor vehicle crashes but similarly arises with sports-related injuries (e.g., clothesline tackle), strangling, blows from the fists or feet, and extreme manipulation (i.e., any manual operation such as chiropractic treatment or physical realignment or repositioning of the spine) [5,6] . In motor vehicle crashes in which the driver is not belted, the driver is in danger of shoving forward with the head extended, forcing the anterior neck in contradiction of the steering column.…”

Section: Blunt Traumamentioning

confidence: 99%

Emergency Airway Management in Neck Trauma

Madkhali

Albati

Ahmad

et al. 2018

Egyptian Journal of Hospital Medicine

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Airway management in patients who have sustained direct trauma to the airway is among the most challenging problems for emergency clinicians. Blunt or penetrating injuries to the head, oropharynx, neck, or upper chest can result in immediate or delayed airway obstruction. Immediate, definitive airway management is needed when the patient cannot protect his airway or is unable to sufficiently oxygenate or ventilate. Emergent or urgent airway management is specified when a patient develops respiratory distress or when symptoms are progressing rapidly. In addition, airway management often is indicated when the patient appears clinically stable, but the clinician anticipates clinical decline (e.g., smoke inhalation, edema, subcutaneous air, hematoma) or feels that an unprotected airway presents a risk to the patient who requires transport to another facility or to radiology for extensive diagnostic studies. The higher rate of complicated airways in this population mandates that the clinician has to be prepared to use advanced airway techniques, including a surgical airway.

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Clinical considerations for blunt laryngotracheal trauma in children

Cited by 17 publications

References 47 publications

Operative Management of Vocal Fold Avulsion Following Pediatric Laryngotracheal Separation

Operative Management of Vocal Fold Avulsion Following Pediatric Laryngotracheal Separation

A túlfújt endotrachealis mandzsetta szerepe a légcsősérülések diagnosztikájában

Emergency Airway Management in Neck Trauma

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