Cricotracheal Separation after Gunshot to the Neck: Report of a Survivor with Recovery of Bilateral Vocal Fold Function

• Published in: The Journal of emergency medicine Vol. 46; no. 2; pp. e27 - e30
• Main Authors: Vivero, Richard J., MD, Saint-Hilaire, Reginald, MD, Bhatia, Rita G., MD, Leibowitz, Jason M., MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-02-2014
• Subjects: Adult; Cricoid Cartilage - injuries; Emergency; Humans; injuries; Male; Neck Injuries - etiology; neck injury; penetrating; Recovery of Function; separation; trachea; Trachea - injuries; trauma; Vocal Cords - injuries; vocal folds; Wounds, Gunshot - complications; trauma; trachea; separation; injuries; penetrating; neck injury; vocal folds
• ISSN: 0736-4679; 2352-5029
• DOI: 10.1016/j.jemermed.2013.08.090

Abstract Background Traumatic tracheal injury via blunt or penetrating mechanism comes with a grave prognosis. Cricotracheal separation is a rare entity among these injuries and even more infrequent by means of penetrating trauma. Resultant airway discontinuity subsequent to these insults causes immense global hypoxia and tends to be uniformly fatal. Objective Our aim was to discuss emergent and surgical management of traumatic airway injury. Case Report We report the case of a 28-year-old male who sustained a gunshot wound to the neck resulting in laryngeal fracture and cricotracheal separation. We review the initial stabilization of his airway and detail the successive surgical management of his injury in the context of the current available literature, with an emphasis on timely airway stabilization when high suspicion for cricotracheal separation exists based on traumatic mechanism. Conclusions Emergent management and stabilization of the airway is critical to survival in the context of trauma involving the neck and airway structures.