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Trends in blunt laryngotracheal trauma in children

Christopher T Wootten1, Matthew A Bromwich, Charles M Myer

  • 1Otolaryngology Head & Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229-3039, USA. ctwootten@gmail.com

International Journal of Pediatric Otorhinolaryngology
|June 9, 2009
PubMed

Insights

Blunt laryngotracheal trauma is increasing in children, often due to motor vehicle accidents. While surgical reconstruction can restore airway patency, hoarseness may persist as a long-term issue.

Area of Science:

  • Pediatric Trauma Surgery
  • Laryngotracheal Injury
  • Airway Management

Background:

  • Blunt laryngotracheal trauma presents unique challenges in pediatric patients.
  • Severity of these injuries appears to be increasing.
  • Early recognition and management are crucial for optimal outcomes.

Purpose of the Study:

  • To analyze the presentation, mechanisms, and management of blunt laryngotracheal trauma in children.
  • To highlight the increasing severity of these injuries.
  • To evaluate surgical outcomes and long-term morbidities.

Main Methods:

  • Retrospective analysis of 35 pediatric patients with major laryngotracheal trauma from 1995 to 2008.
  • Data collected on injury presentation, causative mechanisms, management strategies, and patient outcomes.
  • Surgical results, airway patency, voice, swallowing, and residual disabilities were tabulated.

Main Results:

  • The average age of affected children was 10.8 years.
  • Motor vehicle accidents were a common mechanism of injury.
  • Five of 11 major trauma victims were unconscious at presentation, underscoring the need for vigilance.
  • Definitive airway reconstruction, including laryngotracheoplasty and tracheal resection/reanastomosis, was performed.
  • Ten of 11 patients undergoing reconstruction were successfully decannulated.

Conclusions:

  • Major laryngotracheal trauma is increasingly affecting younger children.
  • Associated injuries or altered consciousness can mask airway trauma, necessitating careful evaluation.
  • Surgical airway reconstruction is effective, with most patients achieving decannulation.
  • Persistent hoarseness is a common long-term consequence.
Abstract

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