MDCT in the Assessment of Laryngeal Trauma: Value of 2D Multiplanar and 3D Reconstructions

Becker, Minerva; Duboe, Pier-Olivier; Platon, Alexandra; Köhler, R; Tasu, J.P.; Becker, Christoph; Poletti, Pierre–Alexandre

doi:10.2214/ajr.12.9813

Cited by 22 publications

(19 citation statements)

References 34 publications

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“…If acute laryngeal injury is suspected 2D and 3D CT reconstructions may provide additional diagnostic utility to multiaxial CT imaging [9]. In this study there were no 2D and 3D reconstructions.…”

Section: Discussionmentioning

confidence: 93%

“…Laryngeal trauma is classified as either penetrating or blunt and supraglottic, glottic, or infraglottic. Laryngeal trauma may heal with fibrous union, deformity, and altered laryngeal function even after minor trauma [1–9]. Features of laryngeal trauma include loss of normal anatomic landmarks, tenderness, crepitus, soft tissue emphysema, dysphonia, aphonia, laryngeal obstruction, dyspnea, stridor, hoarseness, neck pain, hemoptysis, dysphagia, and odynophagia [5].…”

Section: Introductionmentioning

confidence: 99%

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Acute Traumatic Injury of the Larynx

Kragha

2015

Case Reports in Otolaryngology

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Laryngeal trauma is rare but serious and potentially deadly injury. The prompt diagnosis and management of acute laryngeal trauma is necessary because the clinical presentation is variable depending on the location, severity, and mechanism of injury. Two case histories are presented: (1) case history A: a 53-year-old male, after motor vehicle accident, fractured the mid anterior thyroid cartilage and both aspects of the cricoid cartilage; however, this patient was asymptomatic from the above fractures; and (2) case history B: a 41-year-old male who sustained trauma to the chest, neck, and left arm after being struck by a large lead pipe which fractured the left aspect of the cricoid cartilage was symptomatic. The type rather than the severity of acute laryngeal injury and the mechanism of injury may be related to symptomatology. Acute laryngeal trauma should be recognized by trauma radiologists and emergency room physicians. Early diagnosis and management of acute laryngeal trauma may prevent unnecessary specialty consults and long-term complications.

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Section: Discussionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Acute Traumatic Injury of the Larynx

Kragha

2015

Case Reports in Otolaryngology

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“…9,10 Diagnostic imaging produced 2 direct effects on ELTI patterns: greater injury recognition and upstaging of injuries from those that may have been considered exclusively mucosal to contain small, nondisplaced fractures. It is not surprising that routine CT detects additional ELTIs, with enhanced details available on 2-and 3-dimensional views, 11 and CT has become an important part of ELTI evaluation. 12,13 Still, it is critical to determine whether these injuries require additional management, particularly in the trauma setting, where a comorbid injury may be life threatening.…”

Section: Discussionmentioning

confidence: 99%

Airway management changes associated with rising radiologic incidence of external laryngotracheal injury

Randall

Rudmik

Ball³

et al. 2018

cjs

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Background: Traumatic laryngeal injuries are uncommon life-threatening injuries that require prompt, rational management of a potentially precarious airway. It is unclear whether the current incidence of laryngotracheal injury is due to enhanced injury detection or increased occurrence. The objective of this study was to evaluate the relations between diagnostic imaging with both initial airway management and surgical treatment in patients with external laryngotracheal injuries (ELTIs) in Alberta. Methods:In this large-scale population-based analysis, we used regional health databases containing inpatient admissions, emergency department visits and trauma service activations employing International Classification of Diseases diagnostic codes to identify all ELTIs diagnosed from Apr. 1, 1995, to Dec. 31, 2011, in adults (age ≥ 16 yr). We evaluated health records and diagnostic imaging for injury features, airway management, operative interventions and hospital length of stay (LOS).Results: Eighty-nine patients met the inclusion criteria. The incidence of ELTIs increased over time, paralleling a rise in detection during the period incorporating greater computed tomography (CT) use (p = 0.002). Endotracheal tube intubation was performed in 8/30 cases (27%) in the pre-CT era, compared to 38/59 cases (64%) in the post-CT era (p = 0.001); the use of surgical intervention remained consistent. The largest contributors to increased endotracheal tube placements were the emergency department and emergency medical services. No change in survival was detected, but mean LOS among patients admitted for minor, isolated ELTIs increased by 2.3 (95% confidence interval 0.14-4.8) days (p = 0.06), mostly for patients admitted under critical care for mechanical ventilation. Conclusion:Management of ELTIs shifted from predominantly conservative airway monitoring to endotracheal tube intubation over the study period in spite of no clinically significant change in injury severity or operative intervention frequency. The location of endotracheal tube placement suggests less comfort with ELTI among first-responder and emergency personnel.

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“…gists. If acute laryngealinjury is suspected, 2D and 3D CT reconstructions may provide additional diagnostic utility to multiaxial CT imaging [8].…”

Section: Discussionmentioning

confidence: 99%

The Role of Computed Tomography in Laryngotracheal Trauma: A Case Series

Alghamdi

Chaudhary

Rajan³

et al. 2018

AJFSFM

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Laryngotracheal injuries are uncommon but often life threatening. Forensically, the assessment of survived cases is usually based on the external findings and several subjective elements such as reports from the involved persons and witnesses. Therefore, the need for more objective methods is crucial for forensic experts. Clinical computed tomography (CT) is sufficiently advanced to provide detailed descriptions of the internal structures. This study aims to evaluate the use of CT in survived and non-survived cases of laryngotracheal trauma. A total of five patients were included in this study (4 survived cases and one deceased). Information and data were collected retrospectively from medical records; radiological images were analyzed. The study involved three cases with injuries which resulted from blunt trauma caused by an alleged boating accident and sporting accidents, as well as two cases with injuries as a result of medical malpractice. During history taking, type of injury may help in early diagnosis and fast provision of treatment to patients. Blunt types of injury may require the help of CT more than acute injuries for early diagnosis and treatment. major neck vessels opacified normally. Case Three: The CT scan showed extensive air leak a with large volume of subcutaneous emphysema, pneumomediastinum, pneumopericardium and right pneumotho

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MDCT in the Assessment of Laryngeal Trauma: Value of 2D Multiplanar and 3D Reconstructions

Abstract: The use of 2D MPR and 3D volume rendering with or without virtual endoscopy improved assessment of thyroid and hyoid bone fractures, arytenoid luxations, and laryngotracheal narrowing, providing helpful data for optimal management.

Cited by 22 publications

References 34 publications

Acute Traumatic Injury of the Larynx

Acute Traumatic Injury of the Larynx

Airway management changes associated with rising radiologic incidence of external laryngotracheal injury

The Role of Computed Tomography in Laryngotracheal Trauma: A Case Series

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