Laryngeal trauma

Fraga, Gustavo Pereira; Mantovani, Mario; Hirano, Elcio Shiyoiti; Crespo, Agrício Nubiato; Horovitz, Ana Paula Novaes Campello
Rev. Col. Bras. Cir. 31(6): 380-385, ILUS, TAB. 2004 Dec.


BACKGROUND: Evaluate the procedures and results in the treatment of the traumatic lesions of larynx.
METHODS: Descriptive study on 35 patients with laryngeal trauma treated between January 1990 and April 2003.
RESULTS: Predominant mechanism was the penetrant trauma (85.7%), the majority by gunshot wounds (48.6%). Ten patients (28.6%) required endotracheal intubation at the emergency room and mean RTS value was 7.28. The most frequent finding were exposition of laringeal cartilages (30%). In patients sustaining blunt trauma, the most frequent finding was subcutaneous emphysema. Optic fiber laringoscopy was perfomed in four cases. Surgical treatment was required in 34 patients (97.1%) and one was treated nonoperatively. The suture was performed in 33 patients associated with tracheostomy in 24 cases. The thyroid cartilage was the most frequently injured (57.1%). Cervical lesions associated occurred in 20 cases (57.1%). The mean ISS and TRISS values were, respectively, 16.3 and 0.93. The morbidity after laryngeal trauma was 34.3%. Reoperation was required in two patients, one due to cervical abscess and another, lately, by supraglottic stenosis, this last treated with a prothesis. Postoperative mortality was 5.7%.
CONCLUSION: The standard management patients with laringeal trauma results in minor incidence of definitive sequels.

Key words: Injuries; Neck; Larynx; Tracheostomy; Neck injuries


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