Nontraumatic Laryngeal Fractures: Report of Two Cases and Review of the Literature

Abstract

Laryngeal fractures occur mainly in the context of cervical trauma, hanging, or strangulation. Nontraumatic laryngeal fractures are rare and there are few reports in the literature. We present two cases of nontraumatic laryngeal fractures evaluated in our service.

A Case of Laryngeal Fracture Precipitated by Swallowing

“…All reported tenderness and swelling over the thyroid cartilage on examination. FNE findings included unilateral vocal cord oedema [4,5,7] and false cord haematoma [2,3,7]. Vocal cord movement was intact in all cases.…”

“…Non-traumatic laryngeal fractures are exceedingly rare. Since the first reported case in 1950 [2] there have only been six other cases described ( While four cases described a fracture occurring after sneezing [2][3][4]7], and two reported it after coughing [5,6], there has only been one that mentioned a fracture occurring after swallowing [3]. In that case, symptoms started abruptly after the patient swallowed while bending over during dinner.…”

“…Vocal cord movement was intact in all cases. Common findings on CT were of a non-displaced [3,4,6,7], or mildly displaced [5], anterior parasagittal laryngeal fracture. All patients were managed conservatively with observation and vocal rest, and made a full recovery.…”

“…While four cases described a fracture occurring after sneezing [ 2 - 4 , 7 ], and two reported it after coughing [ 5 , 6 ], there has only been one that mentioned a fracture occurring after swallowing [ 3 ]. In that case, symptoms started abruptly after the patient swallowed while bending over during dinner.…”

“…Non-traumatic laryngeal fractures are very rare. A total of only seven cases have been reported in the literature, with sneezing, coughing and swallowing described as the precipitating events [2][3][4][5][6][7]. While blunt trauma to the neck would prompt active and thorough assessment for a laryngeal fracture, clinicians may not be aware that this type of injury can also occur after a seemingly innocuous event.…”