External trauma to the larynx : classification, diagnosis, therapy

In contrast to internal trauma to the larynx caused by endolaryngeal procedures, trauma to the larynx caused by external forces is relatively rare. Nevertheless, the great variety of these external traumata warrants a thorough diagnosis and understanding of each case as well as a standardized and ac...

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Bibliographic Details
Published in:	European archives of oto-rhino-laryngology Vol. 257; no. 8; pp. 439 - 444
Main Authors:	KLEINSASSER, Norbert H, PRIEMER, Fritz G, SCHULZE, Walter, KLEINSASSER, Oskar F
Format:	Journal Article
Language:	English
Published:	Berlin Springer 2000
Subjects:	Biological and medical sciences Ent, stomatology, face, injuries. Foreign bodies. Diseases due to physical agents: otorhinolaryngology Humans Larynx - injuries Larynx - surgery Medical sciences Rupture Traumas. Diseases due to physical agents Treatment Outcome Wounds, Nonpenetrating - classification Wounds, Nonpenetrating - diagnosis Wounds, Nonpenetrating - etiology Wounds, Nonpenetrating - surgery Wounds, Penetrating - classification Wounds, Penetrating - diagnosis Wounds, Penetrating - etiology Wounds, Penetrating - surgery Human Radiodiagnosis Sequela Trauma Mechanism Treatment Classification External Medical imagery ENT disease Larynx Application method Computerized axial tomography Larynx disease Diagnosis
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Summary:	In contrast to internal trauma to the larynx caused by endolaryngeal procedures, trauma to the larynx caused by external forces is relatively rare. Nevertheless, the great variety of these external traumata warrants a thorough diagnosis and understanding of each case as well as a standardized and accepted method for classifying these injuries. These preconditions will facilitate successful therapy. At our three institutions cases of external trauma to the larynx, including the mechanisms of trauma, were reviewed and analyzed. Cases were classified according to the mechanisms and the sequelae of trauma. The three major categories were (a) external trauma due to the impact of blunt objects, (b) trauma after tearing of the neck and the larynx longitudinally, and (c) external trauma caused by sharp objects and gunshots. In the great majority of cases external trauma to the larynx was caused by blunt pressure and was most often due to strangulation in the course of (attempted) suicide or homicide. In a smaller number of cases sharp instruments caused external traumata. In patients surviving the immediate trauma a meticulous laryngological assessment is necessary. In addition to indirect laryngoscopy, we consider microlaryngoscopy as being indicated for investigating the soft tissues of the endolarynx. The status of the laryngeal skeleton can be determined more precisely via high-resolution computed tomography and ultrasound. Early diagnosis and appropriate therapy have a significant impact on the patient's condition later, especially as regards scar formation, ease of breathing, and voice quality.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0937-4477 1434-4726
DOI:	10.1007/s004050000263