Laryngeal injury: a critical review

Thirty consecutive cases of laryngeal trauma requiring open exploration are reviewed. Eighteen injuries were the result of blunt trauma and 12 resulted from penetrating wounds. Within the blunt trauma group, eight of 18 injuries resulted in a competent airway and a good voice, six with a good airway but a fair voice, and four with airway compromise. Of 12 patients with penetrating wounds, ten sustained a good airway and a good voice, two a good airway and fair voice. Substantial granulation tissue response, though occurring in only eight of the 30 patients, was present in three of the four patients with airway stenosis. The use of a stent, in association with a soft tissue graft when mucosal loss cannot be approximated primarily, does not predispose to such a response, but rather facillitates maintenance of a competent skeletal framework and prevention of soft tissue endolaryngeal distortion.