title: Laryngeal fracture due to blunt trauma presenting with pneumothorax and pneumomediastinum.
abstract: OBJECTIVE
  Injuries due to traffic accidents are frequent in childhood, and they have high mortality and morbidity. Laryngeal injury due to a traffic accident is a rare pathology and might be missed if not suspected. Here we present a laryngeal fracture in a child after a blunt chest trauma during a traffic accident that presented with pneumomediastinum and pneumothorax.
  
  
  METHODS
  A 14-year-old girl was referred for pneumomediastinum. Her physical examination was normal except subcutaneous emphysema, edema and tenderness in the cervical area, hoarseness, facial and extremity abrasions and ecchymoses. Chest tomography revealed pneumothorax and pneumomediastinum, and cranial tomography revealed maxillofacial fractures. Upper airway damage was suspected, flexible endoscopy revealed right vocal cord paralysis and cervical tomography revealed thyroid cartilage fracture. The fracture was repaired and tracheotomy was performed. She was discharged on postoperative day 6. Facial fractures were repaired in another center. Tracheotomy was removed on postoperative day 20. Her hoarseness, although decreased, still persists.
  
  
  CONCLUSIONS
  Pneumomediastinum is a rare result of a laryngeal fracture and if not suspected, the fracture can easily be missed. It should be kept in mind after blunt cervical trauma with pneumomediastinum and/or pneumothorax. Direct endoscopy and cervical tomography may be necessary for the differential diagnosis.
authors.affiliation: Departments of Pediatric Surgery and Otorhinolaryngology, Afyon Kocatepe University Medical Faculty, Afyon, Turkey. adnannarci@yahoo.com
authors.forename: Adnan
authors.initials: A
authors.lastname: Narcı
authors.forename: Didem Baskın
authors.initials: DB
authors.lastname: Embleton
authors.forename: Abdullah
authors.initials: A
authors.lastname: Ayçiçek
authors.forename: Fatih
authors.initials: F
authors.lastname: Yücedağ
authors.forename: Salih
authors.initials: S
authors.lastname: Cetinkurşun
mesh_terms: D000063:Accidents, Traffic; D000293:Adolescent; D003937:Diagnosis, Differential; D004322:Drainage; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007818:Laryngeal Diseases / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D007830:Larynx / Q000293:injuries*; D008478:Mediastinal Emphysema / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods; D011030:Pneumothorax / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D013898:Thoracic Injuries / Q000150:complications* / Q000175:diagnosis; D013957:Thyroid Cartilage / Q000293:injuries*; D014057:Tomography, X-Ray Computed; D014949:Wounds, Nonpenetrating / Q000150:complications* / Q000175:diagnosis