Laryngotracheal trauma: recognition and management

In 23 patients with laryngotracheal trauma at the Louisville General Hospital during a ten-year period, 19 survived. One death was directly atributable to the airway injury. The most common postinjury complication was hoarsensess attributable to direct injury to the cords or recurrent nerve paralysis. One patient had further operation for subglottic stenosis. In general, blunt injuries were more severe than penetrating injuries. Subcutaneous emphysema, aphonia or dyshonia, hemoptysis, signs of injuries, a sucking wound, are presumptive findings of laryngotracheal injury. Appropriate endoscopy and radiographic studies should confirm the diagnosis. Control of the airway is achieved by emergency tracheostomy or intubation followed by tracheostomy. Prompt operative intervention and primary repair follow.