title: Conservative management of laryngeal dog bite.
abstract: OBJECTIVE
  Dog bites represent an important public health issue, causing injuries from trivial to fatal. The true incidence is unknown due to the lack of national and local reporting system. School children, mostly male, are more commonly affected with the majority of injuries occurring in the head and neck area, followed by the limbs and trunk.
  
  
  METHODS
  The conservative management of a 6-year-old girl who sustained a fracture of her laryngeal structure from an attack by her neighbours' dog is described. Only a 1 cm visible puncture wound in the midline of her neck with air escaping through the wound was seen at presentation.
  
  
  RESULTS
  Ten days were spent in hospital including the first four in intubated Paediatric Intensive Care Unit. Initial microlaryngoscopy and bronchoscopy (MLB) showed a swelling in the right anterior subglottis not reducible by manipulation. She was re-intubated with progressively larger naso-tracheal tube until the fracture was fully reduced on her 3rd MLB. Three months post-injury, there is no evidence of airway narrowing.
  
  
  CONCLUSIONS
  The literature advocates early surgical management of laryngeal trauma including dog bites. Conservative management of laryngeal fracture from a dog bite is feasible and associated with a good outcome and no long-term sequela.
authors: Otolaryngology - Head and Neck Surgery, Department of Paediatric Otolaryngology, Southern General Hospital, UK. n.oozeer@googlemail.com
authors: N B
authors: NB
authors: Oozeer
authors: R
authors: R
authors: Fairgrieve
authors: W A
authors: WA
authors: Clement
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001733:Bites and Stings / Q000503:physiopathology / Q000601:surgery*; D001999:Bronchoscopy; D002648:Child; D003422:Critical Care; D004285:Dogs; D005260:Female; D005931:Glottis / Q000293:injuries*; D006801:Humans; D007442:Intubation, Intratracheal; D007828:Laryngoscopy; D007830:Larynx / Q000293:injuries*; D019838:Neck Injuries / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome; D014945:Wound Healing; D014950:Wounds, Penetrating / Q000473:pathology / Q000601:surgery*
chemical_list: D000900:Anti-Bacterial Agents
keywords: Dog bite; laryngeal fracture