Vocal fold avulsion in the pediatric population: Presentation and management

Strychowsky, Julie E.; Adil, Eelam; Licameli, Greg R.; Rahbar, Reza

doi:10.1016/j.ijporl.2015.04.046

Cited by 2 publications

(2 citation statements)

References 15 publications

(57 reference statements)

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“…Of the reported cases, the majority of vocal fold avulsions are minor in severity and able to be reapproximated endoscopically. 8 There are 2 prior reported cases of open repair of the vocal process, both performed when in the presence of existing fracture to the cartilaginous laryngeal framework, using existing laryngofissures to access the repair as was performed here. 9 In contrast to these reports, the case herein describes complete avulsion of the vocal fold and mucosa of the conus elasticus, requiring a repair of the entire margin of the vocal fold and repositioning of the arytenoid concurrently.…”

Section: Discussionmentioning

confidence: 98%

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: 98%

Operative Management of Vocal Fold Avulsion Following Pediatric Laryngotracheal Separation

Chang

Schoppy

et al. 2019

Ear Nose Throat J

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“…A laryngeal microfracture that appeared to be below the resolution of CT was identified by micro-CT in a report by Fais et al [16]. Occult fractures that are not visible in clinical CT following blunt trauma have been repeatedly described in pediatric populations with an entirely cartilaginous laryngeal skeleton [17,18].…”

Section: Introductionmentioning

confidence: 99%

Thyroid cartilage asymmetry as a potential diagnostic finding for occult cartilaginous fractures for the evaluation of nonfatal manual strangulation

et al. 2021

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Objective: This study is based on the hypothesis that occult cartilaginous fractures of the thyroid cartilage (TC) may result in asymmetry of the thyroid cartilage framework. Justification of this hypothesis was provided by an estimation of the prevalence of TC asymmetry based on a consecutive postmortem study group. The findings were then compared to three cases of nonfatal manual strangulation and one case of survival of blunt trauma to the neck. Methodology: TC images from a consecutive two-year sample from the institutional postmortem computed tomography database (N= 1187) were assessed. Cases with acute TC injury were excluded. TC asymmetry, signs of prior TC trauma, sex and age, were retrieved. Results: TC asymmetry was present in 72 cases (6.2%, 67 males). In 40 cases (3.5%), old TC fractures could be identified. The derived odds ratios were 7.48 for male sex and 1.02 for (each year of) age (p <0.001). Asymmetry of the TC laminae was observed significantly more often on the left side (N= 53, 73.6%, p <0.001). Cases 1 and 2 showed TC asymmetries following nonfatal manual strangulation. Cases 3 and 4 illustrated the limited visibility of cartilaginous fractures on computed tomography. Conclusion: TC asymmetry is associated with male sex and older age and is typically located on the left side. TC asymmetry in young and female cases is rare. TC asymmetry in young and/or female cases may result from occult cartilaginous fractures, as cases 1 and 2 indicated. Further research is needed to validate this hypothesis.

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Vocal fold avulsion in the pediatric population: Presentation and management

Cited by 2 publications

References 15 publications

Operative Management of Vocal Fold Avulsion Following Pediatric Laryngotracheal Separation

Operative Management of Vocal Fold Avulsion Following Pediatric Laryngotracheal Separation

Thyroid cartilage asymmetry as a potential diagnostic finding for occult cartilaginous fractures for the evaluation of nonfatal manual strangulation

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