Transcervical intubation for massive self-inflicted neck wound transecting the epiglottis

• Published in: Trauma case reports Vol. 43; p. 100752
• Main Authors: Menke, Bryant A., Spencer, John D., Dowdall, Jayme R.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01-02-2023; Elsevier
• Subjects: Case Report; Epiglottis; Intubation; Larynx; Transcervical; Transection; Trauma; Epiglottis; Larynx; Transcervical; Intubation; Trauma; Transection
• ISSN: 2352-6440; 2352-6440
• DOI: 10.1016/j.tcr.2022.100752

Penetrating trauma to the larynx is a rare phenomenon with a high risk of mortality and morbidity due to the density of vital structures in the area (Demetriades et al., 1996). Most commonly, this type of injury is due to a gunshot wound or knife injury (Snow and Ballenger, 2003). In cases of suicidal cutthroat injury, it is relatively rare to penetrate the airway (Symbas et al., 1976).
We present a case of self-penetrating trauma to the anterior neck allowing access for direct laryngeal visualization and transcervical intubation in the field. We describe the immediate workup, surgical intervention, and postoperative management. We focus on managing postoperative cough, secretion management, decannulation, and resultant dysphagia.
Penetrating laryngeal trauma resulting in airway transection is a rare but potentially fatal phenomenon in which airway management and aggressive post-operative care for severe coughing and dysphagia should be performed to help improve patient outcomes.