Laryngotracheal trauma: its management and sequelae.
OBJECTIVE
Laryngotracheal trauma is a rare but clinically important injury. Complications are frequent. Early recognition, accurate evaluation and proper treatment is vital. In order to learn from our past experience and refine our management, we reviewed our cases


METHODS
Fifteen patients with external laryngotracheal injuries were analyzed retrospectively. The outcome was assessed both in terms of voice and airway, on short term and long term basis.


RESULTS
Commonest cause of injury was cut throat injuries followed by road traffic accidents. The main presenting symptoms and signs were hoarseness, haemoptysis, odynophagia and stridor. Major laryngeal injuries (10 cases) outnumbered minor injuries (5 cases). A good association exists between the symptoms of haemoptysis and stridor at presentation and severity of the injury. Sites of laryngeal injury included; thyroid cartilage, mixed soft tissue and cartilaginous injuries, thyrohyoid membrane, aryepiglottic fold and cricothyroid membrane. Ten patients presented within 24 hours of the injury. Out come (airway and voice) was good in 12 patients whereas it was poor in 3 patients. Poor results were seen in patients who had delayed surgical intervention.


CONCLUSIONS
The presence of stridor and haemoptysis are suggestive of major injury. Early surgical intervention is recommended for all major injuries to ensure a good outcome.
Akhtar
Shabbir
S
Department of Surgery, Aga Khan University Hospital, Karachi.
Awan
Sohail
S
D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007830:Larynx / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D019838:Neck Injuries / Q000175:diagnosis / Q000628:therapy*; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D013898:Thoracic Injuries / Q000175:diagnosis / Q000628:therapy*; D014132:Trachea / Q000293:injuries*; D014139:Tracheostomy / Q000379:methods*; D015599:Trauma Severity Indices; D016896:Treatment Outcome; D014950:Wounds, Penetrating / Q000175:diagnosis / Q000628:therapy*