Observation of tardive laryngeal edema after blunt trauma to the neck is not necessary: a 10-year retrospective analysis.
Patients exposed to blunt laryngeal trauma not requiring immediate attention are usually observed for 24 h in the ward due to the risk of airway obstruction. In some cases without laryngeal edema on initial examination, edema may develop later. This condition is defined as tardive laryngeal edema (TLE) as opposed to progressive laryngeal edema, where the edema is present initially. Though specialists internationally report on TLE-even with severe airway obstruction-we could not find any publications describing it, and the specific definition seems to be used only in Denmark. In order to identify cases of TLE at our clinic a retrospective study over a period of 10 years was undertaken. Of 145 patients included, 6 developed insignificant TLE. None of the patients developed life-threatening TLE. The results of this study indicate that TLE is a rare condition and we suggest that severe life-threatening TLE does not exist. We propose that patients with no laryngeal edema on first examination and with no laryngeal fractures can safely be discharged after primary examination.
Hermansen
Ditte Thorsen
DT
Department of Otorhinolaryngology, Head and Neck Surgery, F 2072, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark. ditteth@hotmail.com
Bilde
Anders
A
Rasmussen
Niels
N
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007819:Laryngeal Edema / Q000175:diagnosis / Q000209:etiology*; D007828:Laryngoscopy / Q000379:methods*; D007830:Larynx / Q000293:injuries*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019838:Neck Injuries / Q000150:complications* / Q000175:diagnosis; D011379:Prognosis; D012189:Retrospective Studies; D013997:Time Factors; D015599:Trauma Severity Indices; D014949:Wounds, Nonpenetrating / Q000150:complications* / Q000175:diagnosis; D055815:Young Adult