title: Laryngeal fractures: clinical findings and considerations on suboptimal outcome.
abstract: CONCLUSIONS
  We recommend early surgical exploration and fixation for patients with dislocated or comminuted laryngeal fractures to avoid long-term voice complications. One-third of 33 fracture patients rated their voice after the fracture had healed as fair but altered.
  
  
  OBJECTIVE
  To examine the indications for and the outcome of surgical management in patients with laryngeal fractures.
  
  
  METHODS
  The study was carried out in a tertiary care referral university hospital and was a retrospective study of case series. Thirty-three consecutive patients, aged 14-84 years, presented with various types of laryngeal fractures. Patients were staged according to the type of the fracture and surgical correction was performed when indicated. Voice outcome was documented and patients with subjectively suboptimal result were further evaluated by phoniatric specialist.
  
  
  RESULTS
  In all, 32 of 33 laryngeal fracture patients had blunt trauma and the main causative factors were sport injuries (39%) and physical assault (33%). All of the 33 laryngeal fracture patients had a good airway outcome. The subjective voice outcome was good for 20 (61%) and fair for 13 (39%) patients. The mean follow-up time was 39.5 months (range 2-114 months). In phoniatric evaluation most (six of eight) patients with fair voice outcome could not produce high pitched voices because of inability to stretch the vocal folds.
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, Helsinki University Central Hospital, Helsinki, Finland.
authors.forename: Marko
authors.initials: M
authors.lastname: Juutilainen
authors.forename: Juha
authors.initials: J
authors.lastname: Vintturi
authors.forename: Soraya
authors.initials: S
authors.lastname: Robinson
authors.forename: Leif
authors.initials: L
authors.lastname: Bäck
authors.forename: Hannu
authors.initials: H
authors.lastname: Lehtonen
authors.forename: Antti A
authors.initials: AA
authors.lastname: Mäkitie
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000402:Airway Obstruction / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D005260:Female; D050724:Fractures, Cartilage / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D007817:Laryngeal Cartilages / Q000293:injuries*; D007828:Laryngoscopy; D007830:Larynx / Q000293:injuries* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D012189:Retrospective Studies; D013018:Sound Spectrography; D014057:Tomography, X-Ray Computed; D014832:Voice Disorders / Q000209:etiology*; D014833:Voice Quality; D014948:Wounds, Gunshot / Q000175:diagnosis / Q000601:surgery*; D014949:Wounds, Nonpenetrating / Q000175:diagnosis / Q000601:surgery*