Pediatric Acute External Laryngeal Trauma

Abstract

Larynx and adjacent anatomical structures have complicated physiological functions and mechanical features. Traffic accidents, penetrating stab wounds and shot wounds, sports matches, and occupational accidents cause external laryngeal trauma. In the management of laryngeal trauma, maintenance of airway patency has priority. In this case report, we will mention of a 15-year-old male patient with a blunt laryngeal trauma and also the approach to laryngeal traumas.

Hypoxic respiratory failure in an adolescent after blunt neck trauma

“…Cricothyrotomy would have been futile in this severe case, likely resulting in a false passage. In unstable patients, after the airway is secured, CT can further evaluate neck and chest injuries 1,6 . Prompt surgical intervention is indicated for severe injuries such as laryngeal cartilage displacement, with open fixation and stents often required to maintain the natural airway lumen and cartilaginous integrity 1,3,6 …”

“…Laryngeal trauma is a rare event, occurring in 1 in 22, 900 ED visits, with approximately 25% experiencing associated thyroid cartilage fracture 1 . Incidence is significantly lower in the paediatric population than in adults, due to the larynx being located more superiorly relative to the neck, and due to greater flexibility of the laryngeal cartilage 2 …”

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Blunt laryngeal trauma is a rare aetiology of acute respiratory failure in the paediatric population. 1 We present the case of a 13-year-old female who presented with cyanosis and respiratory distress after blunt neck trauma, and was found to have laryngeal cartilage fracture with associated subcutaneous emphysema.A 13-year-old female presented to the emergency department (ED) in respiratory distress after falling off a motorised bike. She was riding a bike with her helmet on when she collided with a boat that was protruding from a truck.

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Management of Pediatric Trauma: ENT View

“…The possibility of injury is lower than that of adults because physiologically larynx is more flexible and soft in children [38]. Blunt pediatric external laryngeal trauma usually occurs due to motor vehicle accidents and sports injuries; less commonly, penetrating pediatric external laryngeal trauma occurs due to dog bites, falls onto objects, and penetrating stab wounds [39][40][41].…”

“…Laryngeal trauma can be seen in different forms, such as the fracture of the thyroid cartilage, complicated fractures involving both the thyroid and cricoid cartilages, mucosal lacerations, endolaryngeal hematoma, laceration in thyroepiglottic ligament, unilateral or bilateral recurrent laryngeal nerve injury, cricoarytenoid joint injury, and laryngotracheal dissociation [39]. Since patients may have mild symptoms despite severe trauma, laryngeal trauma should be suspected in all pediatric patients with neck trauma.…”