A Rare Case of Post-Traumatic Open Laryngeal Fracture

Rajkumari P. Khatri

doi:doi:10.11648/j.ijo.20230902.19

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A Rare Case of Post-Traumatic Open Laryngeal Fracture

Rajkumari P. Khatri

Published in International Journal of Otorhinolaryngology (Volume 9, Issue 2)

Received: 15 September 2023 Accepted: 7 October 2023 Published: 18 December 2023

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Abstract

Laryngeal fracture is a rare and potentially fatal traumatic injury, with an estimated incidence of 1 in 30,000 patients admitted to severe trauma centres. This is usually seen in multiple-trauma patients and is often undiagnosed or poorly managed leading to significant problems with airway patency, voice production, and swallowing; and the overall mortality rate being as high as 17.9%. This paper reports a case of a 28-year-old male patient, whose motorcycle accidentally hit a truck. The patient presented with a lacerated open neck wound with multiple small lacerated wounds on the skin over the neck and chin. The CT scan revealed a severe burst injury of the anterior larynx with fractured thyroid laminae, and the larynx was exposed to the external surface. Method: A series of investigations followed, including assessing patient’s medical records, performing medical and surgical interventions and lastly taking patient feedback. Results: Early intervention with an open reduction and internal fixation of the thyroid cartilage helped restore the near-normal anatomy of the larynx. Post-operatively, he had no problems in swallowing or breathing; except for some hoarseness of voice, which improved considerably within six months post-surgery. Conclusions: Because of the rarity of this injury, physicians may not be aware of its occurrence, leading to a late diagnosis of this entity. Early diagnosis of the laryngeal injury is indispensable. The most important goal in management initially is to secure and reconstruct the airway; thereafter; the long-term goal of treatment is to restore the voice and swallowing mechanism.

Published in	International Journal of Otorhinolaryngology (Volume 9, Issue 2)
DOI	10.11648/j.ijo.20230902.19
Page(s)	35-39
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Laryngeal Trauma, Laryngeal Fracture, Thyroid Cartilage Fracture, Cut-Throat Injury, Blunt Neck Injury

References

[1]	Hicham Attif, Ayman Elfarouki, Karim Nadour, Mounir Hmidi, Nabil Touihem, Ali Elboukhari, Brahim Zainoun. Diagnosis and management of laryngeal fracture: a case report. International Journal of Otorhinolaryngology and Head and Neck Surgery. 2017; 3 (4): 1095-1098.
[2]	G. S. Gussack, G. J. Jurkovich, and A. Luterman, “Laryngotracheal trauma: a protocol approach to a rare injury,” Laryngoscope, vol. 96, no. 6, pp. 660–665, 1986. View at: Google Scholar.
[3]	Statpearls.com, Laryngeal Fracture Article. Available from: https://www.statpearls.com/Article library/viewarticle/24038#ref-7114721.
[4]	S. D. Schaefer, “The acute management of external laryngeal trauma. A 27-year experience,” Archives of Otolaryngology—Head and Neck Surgery, vol. 118, no. 6, pp. 598–604, 1992. View at: Publisher Site \| Google Scholar.
[5]	Philicia Moonsamy, Uma M. Sachdeva, Christopher R. Morse. Management of laryngotracheal trauma. Ann Cardiothorac Surg 2018; 7 (2): 210-216.
[6]	Nadir Elias, James Thomas, Allen Cheng. Management of Laryngeal Trauma. Oral Maxillofac Surg. 2006; 64 (2): 203-14.
[7]	Nuno Ribeiro-Costa, Pedro Carneiro Sousa, Diogo Abreu Pereira, Paula Azevedo, and Delfim Duarte. Laryngeal Fracture after Blunt Cervical Trauma in Motorcycle Accident and Its ManagementCase Reports in Otolaryngology Volume 2017, Article ID 9321975, 3 pages https://doi.org/10.1155/2017/9321975
[8]	Bassel Hallak, Sonia Von Wihl, Franciscus Boselie, Salim Bouayed. Repair of displaced thyroid cartilage fracture using miniplate osteosynthesis. BMJ Case Rep 2018; 11: e226677. doi: 10.1136/bcr-2018-226677.
[9]	Nathan Schaefer, Aaron Griffin, Benjamin Gerhardy, Peter Gochee. Early Recognition and Management of Laryngeal Fracture: A Case Report. The Ochsner Journal 2014; 14: 264–265.
[10]	Mendelsohn AH, Sidell DR, Berke GS, John MS. Optimal timing of surgical intervention following adult laryngeal trauma. Laryngoscope. 2011 Oct; 121 (10): 2122-2127. Epub 2011 Sep 6.
[11]	Butler AP, Wood BP, O’Rourke AK, Porubsky ES. Acute external laryngeal trauma: experience with 112 patients. Ann OtolRhinolLaryngol. 2005 May; 114 (5): 361-368.
[12]	Pou AM, Shoemaker DL, Carrau RL, Snyderman CH, Eibling DE. Repair of laryngeal fractures using adaptation plates. Head & neck. 1998 Dec: 20 (8): 707-13 [PubMed PMID: 9790292].
[13]	Duda JJ Jr, Lewin JS, Eliachar I. MR evaluation of epiglottic disruption. AJNR Am J Neuroradiol. 1996 Mar; 17 (3): 563-6. PMID: 8881254; PMCID: PMC8338005.
[14]	Burak Ulkumen, Onur Celik, Nevin Sahin. Open Laryngeal Fracture: A case report and review of the literature. Medical Science and Discovery. 2015; 2 (5): 304-07.
[15]	Dray TG, Coltrera MD, Pinczower EF. Thyroid cartilage fracture repair in rabbits: comparing healing with wire and miniplate fixation. Laryngoscope 1999; 109: 118–22.
[16]	Kuttenberger JJ, Hardt N, Schlegel C. Diagnosis and initial management of laryngotracheal injuries associated with facial fractures. Journal of cranio-maxillo-facial surgery: Official publication of the European Association for Cranio-maxillo-facial Surgery. 2004 Apr: 32 (2): 80-4 [PubMed PMID: 14980586].
[17]	AJewett BS, Shockley WW, Rutledge R. External laryngeal trauma analysis of 392 patients. Archives of otolaryngology--head & neck surgery. 1999 Aug: 125 (8): 877-80 [PubMed PMID: 10448735].
[18]	Jalisi S, Zoccoli M. Management of laryngeal fractures--a 10-year experience. Journal of Voice: Official journal of the Voice Foundation. 2011 Jul: 25 (4): 473-9. doi: 10.1016/j.jvoice.2009.12.008. Epub 2010 Mar 17 [PubMed PMID: 20236793].
[19]	Kurien M, Zachariah N. External laryngotracheal trauma in children. International journal of pediatric otorhinolaryngology. 1999 Aug 5: 49 (2): 115-9 [PubMed PMID: 10504017].

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APA Style

P. Khatri, R. (2023). A Rare Case of Post-Traumatic Open Laryngeal Fracture. International Journal of Otorhinolaryngology, 9(2), 35-39. https://doi.org/10.11648/j.ijo.20230902.19

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ACS Style

P. Khatri, R. A Rare Case of Post-Traumatic Open Laryngeal Fracture. Int. J. Otorhinolaryngol. 2023, 9(2), 35-39. doi: 10.11648/j.ijo.20230902.19

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AMA Style

P. Khatri R. A Rare Case of Post-Traumatic Open Laryngeal Fracture. Int J Otorhinolaryngol. 2023;9(2):35-39. doi: 10.11648/j.ijo.20230902.19

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@article{10.11648/j.ijo.20230902.19,
  author = {Rajkumari P. Khatri},
  title = {A Rare Case of Post-Traumatic Open Laryngeal Fracture},
  journal = {International Journal of Otorhinolaryngology},
  volume = {9},
  number = {2},
  pages = {35-39},
  doi = {10.11648/j.ijo.20230902.19},
  url = {https://doi.org/10.11648/j.ijo.20230902.19},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijo.20230902.19},
  abstract = {Laryngeal fracture is a rare and potentially fatal traumatic injury, with an estimated incidence of 1 in 30,000 patients admitted to severe trauma centres. This is usually seen in multiple-trauma patients and is often undiagnosed or poorly managed leading to significant problems with airway patency, voice production, and swallowing; and the overall mortality rate being as high as 17.9%. This paper reports a case of a 28-year-old male patient, whose motorcycle accidentally hit a truck. The patient presented with a lacerated open neck wound with multiple small lacerated wounds on the skin over the neck and chin. The CT scan revealed a severe burst injury of the anterior larynx with fractured thyroid laminae, and the larynx was exposed to the external surface. Method: A series of investigations followed, including assessing patient’s medical records, performing medical and surgical interventions and lastly taking patient feedback. Results: Early intervention with an open reduction and internal fixation of the thyroid cartilage helped restore the near-normal anatomy of the larynx. Post-operatively, he had no problems in swallowing or breathing; except for some hoarseness of voice, which improved considerably within six months post-surgery. Conclusions: Because of the rarity of this injury, physicians may not be aware of its occurrence, leading to a late diagnosis of this entity. Early diagnosis of the laryngeal injury is indispensable. The most important goal in management initially is to secure and reconstruct the airway; thereafter; the long-term goal of treatment is to restore the voice and swallowing mechanism.
},
 year = {2023}
}

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TY - JOUR
T1 - A Rare Case of Post-Traumatic Open Laryngeal Fracture
AU - Rajkumari P. Khatri
Y1 - 2023/12/18
PY - 2023
N1 - https://doi.org/10.11648/j.ijo.20230902.19
DO - 10.11648/j.ijo.20230902.19
T2 - International Journal of Otorhinolaryngology
JF - International Journal of Otorhinolaryngology
JO - International Journal of Otorhinolaryngology
SP - 35
EP - 39
PB - Science Publishing Group
SN - 2472-2413
UR - https://doi.org/10.11648/j.ijo.20230902.19
AB - Laryngeal fracture is a rare and potentially fatal traumatic injury, with an estimated incidence of 1 in 30,000 patients admitted to severe trauma centres. This is usually seen in multiple-trauma patients and is often undiagnosed or poorly managed leading to significant problems with airway patency, voice production, and swallowing; and the overall mortality rate being as high as 17.9%. This paper reports a case of a 28-year-old male patient, whose motorcycle accidentally hit a truck. The patient presented with a lacerated open neck wound with multiple small lacerated wounds on the skin over the neck and chin. The CT scan revealed a severe burst injury of the anterior larynx with fractured thyroid laminae, and the larynx was exposed to the external surface. Method: A series of investigations followed, including assessing patient’s medical records, performing medical and surgical interventions and lastly taking patient feedback. Results: Early intervention with an open reduction and internal fixation of the thyroid cartilage helped restore the near-normal anatomy of the larynx. Post-operatively, he had no problems in swallowing or breathing; except for some hoarseness of voice, which improved considerably within six months post-surgery. Conclusions: Because of the rarity of this injury, physicians may not be aware of its occurrence, leading to a late diagnosis of this entity. Early diagnosis of the laryngeal injury is indispensable. The most important goal in management initially is to secure and reconstruct the airway; thereafter; the long-term goal of treatment is to restore the voice and swallowing mechanism.

VL - 9
IS - 2
ER -

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Rajkumari P. Khatri

ENT & Head and Neck Oncology Center, Indore, India

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APA Style

P. Khatri, R. (2023). A Rare Case of Post-Traumatic Open Laryngeal Fracture. International Journal of Otorhinolaryngology, 9(2), 35-39. https://doi.org/10.11648/j.ijo.20230902.19

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ACS Style

P. Khatri, R. A Rare Case of Post-Traumatic Open Laryngeal Fracture. Int. J. Otorhinolaryngol. 2023, 9(2), 35-39. doi: 10.11648/j.ijo.20230902.19

Copy | Download

AMA Style

P. Khatri R. A Rare Case of Post-Traumatic Open Laryngeal Fracture. Int J Otorhinolaryngol. 2023;9(2):35-39. doi: 10.11648/j.ijo.20230902.19

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@article{10.11648/j.ijo.20230902.19,
  author = {Rajkumari P. Khatri},
  title = {A Rare Case of Post-Traumatic Open Laryngeal Fracture},
  journal = {International Journal of Otorhinolaryngology},
  volume = {9},
  number = {2},
  pages = {35-39},
  doi = {10.11648/j.ijo.20230902.19},
  url = {https://doi.org/10.11648/j.ijo.20230902.19},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijo.20230902.19},
  abstract = {Laryngeal fracture is a rare and potentially fatal traumatic injury, with an estimated incidence of 1 in 30,000 patients admitted to severe trauma centres. This is usually seen in multiple-trauma patients and is often undiagnosed or poorly managed leading to significant problems with airway patency, voice production, and swallowing; and the overall mortality rate being as high as 17.9%. This paper reports a case of a 28-year-old male patient, whose motorcycle accidentally hit a truck. The patient presented with a lacerated open neck wound with multiple small lacerated wounds on the skin over the neck and chin. The CT scan revealed a severe burst injury of the anterior larynx with fractured thyroid laminae, and the larynx was exposed to the external surface. Method: A series of investigations followed, including assessing patient’s medical records, performing medical and surgical interventions and lastly taking patient feedback. Results: Early intervention with an open reduction and internal fixation of the thyroid cartilage helped restore the near-normal anatomy of the larynx. Post-operatively, he had no problems in swallowing or breathing; except for some hoarseness of voice, which improved considerably within six months post-surgery. Conclusions: Because of the rarity of this injury, physicians may not be aware of its occurrence, leading to a late diagnosis of this entity. Early diagnosis of the laryngeal injury is indispensable. The most important goal in management initially is to secure and reconstruct the airway; thereafter; the long-term goal of treatment is to restore the voice and swallowing mechanism.
},
 year = {2023}
}

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VL - 9
IS - 2
ER -

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