Genioglossus hemorrhage after blunt facial trauma

We present the case of a 28-year-old man admitted to a Level I trauma center after a motorcycle crash in which he sustained blunt trauma to the face and neck, including a mandibular ramus fracture. The patient had no airway compromise on admission, but he acutely developed significant partial upper airway obstruction necessitating emergency endotracheal intubation and subsequent tracheostomy approximately 36 hours after admission. This obstruction was caused by an expanding hematoma of the genioglossus muscle. Potential causes of this complication are presented, and signs and symptoms of upper airway obstruction and airway management strategies are discussed. The etiology of traumatic upper airway obstruction is reviewed.