Yonsei Med J.  2012 Sep;53(5):992-998.

Analysis of Clinical Feature and Management of Laryngeal Fracture: Recent 22 Case Review

• Kim JP
• Cho SJ
• Son HY
• Park JJ
• Woo SH

Abstract

PURPOSE
Laryngeal fracture is rare, but complications are frequent and severe. Controversy still exists in regards to its proper management. The aim of this study was to present the clinical findings and management of laryngeal fracture in Korea.
MATERIALS AND METHODS
We analyzed the medical records of 22 patients with laryngeal fracture at a tertiary care trauma center from 2000 to 2010 retrospectively.
RESULTS
In total, 22 patients (19 men and 3 woman) presented with laryngeal fractures caused by blunt (n=13) or penetrating (n=9) injury. Pain (68.1%), odynophagia (68.1%), hoarseness (18.1%), hemoptysis (13.6%), and subcutaneous emphysema (9%) were the common presenting symptoms and noncomminuted fracture was common. High velocity blunt trauma (mostly traffic accidents) patients had more extensive injury and poor voice outcomes. Penetrating trauma patients due to physical assault or suicide attempt demonstrated more frequently injuries on the left side.
CONCLUSION
In driver-caused traffic accidents, where injuries in a wide area within the larynx occurred, poor voice results were seen, and these injuries required aggressive treatment. When endotracheal intubation was performed at experienced emergency centers with fiberoptic laryngoscopes, airway management was safely achieved. In addition, if the fractured laryngeal framework was corrected at appropriate times, voice results were good.

Keyword

Larynx; fracture; voice; cartilage; injury

MeSH Terms

Accidents, Traffic
Airway Management
Cartilage
Emergencies
Hemoptysis
Hoarseness
Humans
Intubation, Intratracheal
Korea
Laryngoscopes
Larynx
Male
Medical Records
Retrospective Studies
Subcutaneous Emphysema
Suicide
Tertiary Healthcare
Trauma Centers
Voice

Figure

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  Fig. 1 Severity of laryngeal injury (Schaefer Fuhrman's classification). LT, laryngo tracheal.

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  Fig. 2 Causes of laryngeal fracture.

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  Fig. 3 Subsite of injury in laryngeal fracture.

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  Fig. 4 Severity of laryngeal fracture due to driver-caused TAs and non-driver-caused TAs. TA, traffic accident.

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  Fig. 5 Characteristic features of penetrating injury with laryngeal fracture.

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  Fig. 6 Operating management of laryngeal fracture. ORIF, open reduction & internal fixation.

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