Maxillofacial Fractures Associated With Laryngeal Injury

Abstract

Objective Maxillofacial fractures with concomitant laryngeal injuries put both the quality and maintenance of life in jeopardy. Because of its low incidence, it is often overlooked in the clinical setting. The purpose of this study is to review the incidence, clinical presentations, managements, and outcomes of these patients. Methods A retrospective analysis of medical records from 2008 to 2015 was conducted at a single institute. A case series (n = 12, which contributed 22.2% of laryngeal injuries in our institute) of these patients was presented, and propensity score matching was applied for further statistical analysis. Results When comparing patients who sustained maxillofacial fractures with concomitant laryngeal injuries with patients with only maxillofacial fractures and no laryngeal injuries, subcutaneous emphysema (83.3% vs 4.2%, P < 0.001), neck pain (75.0% vs 6.3%, P < 0.001), dyspnea (75.0% vs 0%, P < 0.001), hoarseness (41.7% vs 0%, P < 0.001), neck swelling (66.7% vs 4.2%, P = 0.012), stridor (16.7% vs 0%, P = 0.037), hemoptysis (16.7% vs 0%, P = 0.037), and thoracic trauma (58.3% vs 10.4%, P = 0.001) all showed significant differences. The length of intensive care unit stay (7.42 days vs 3.21 days, P = 0.008), ventilator use (66.7% vs 18.8%, P = 0.002), and tracheostomy (58.3% vs 0%, P < 0.001) were also significantly different. Conclusions A significant portion of laryngeal injuries is concurrent with maxillofacial fractures. As a craniofacial surgeon, we should be alert to the signs of laryngeal injury. Diagnosis of laryngeal injuries should be established before definitive surgery for maxillofacial fractures.

Maxillofacial Fractures: A Four-Year Retrospective Study of 1828 Cases in West China

“…Maxillofacial fractures are prone to cause facial deformities and stomatognathic dysfunctions that affect patients' social activities and quality of life, further leading to economic difficulties and psychological problems [1][2][3]. Craniocerebral injury, dyspnea, massive hemorrhage, eye trauma, and cervical vertebral fractures may also occur, and the patient's life may even be threatened in severe cases because of the special anatomical location of the jawbone [4][5][6][7][8]. For children in the peak stage of growth, fractures involving the growth and development center of the jawbone may also have irreversible effects on facial growth and development [9].…”