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Usefulness of ultrasound examination in larynx traumas in children
Anna Jakubowska1, Lidia Zawadzka-Głos, Michał Brzewski
1Department of Pediatric Radiology, Medical University of Warsaw, Warsaw, Poland.
Insights
Ultrasonography (US) aids in diagnosing pediatric laryngeal trauma, assessing vocal cord mobility, and evaluating neck soft tissues. This imaging technique shows high conformity with laryngoscopy findings in children.
Area of Science:
- Pediatric Traumatology
- Diagnostic Imaging
- Otolaryngology
Background:
- Laryngeal trauma in children presents diagnostic challenges.
- Accurate assessment of laryngeal injuries is crucial for effective treatment and monitoring.
- Conventional diagnostic methods may have limitations in evaluating soft tissue and vocal cord function.
Purpose of the Study:
- To evaluate the diagnostic utility of ultrasonography (US) in pediatric laryngeal trauma.
- To assess the role of US in monitoring treatment progress and identifying complications.
- To compare US findings with laryngoscopy and radiological examinations.
Main Methods:
- A cohort of 12 children (aged 5-12 years) with laryngeal injuries underwent diagnosis and treatment.
- All patients received neck and larynx US with a high-frequency linear transducer.
- Laryngoscopy and radiological examinations of the cervical spine and chest were also performed.
Main Results:
- US identified unilateral vocal cord immobility (5 children), asymmetric mobility (1 child), fractured thyroid cartilage with hematoma (2 children), and thickened vocal cords (5 children).
- Radiological examination revealed subcutaneous emphysema (4 children) and mediastinal emphysema (2 children).
- US demonstrated high conformity with laryngoscopic findings regarding vocal cord mobility and laryngeal structures.
Conclusions:
- Ultrasonography is valuable for assessing the extent of laryngeal trauma in children, particularly vocal cord mobility and soft tissue injury.
- US findings correlate well with laryngoscopic evaluations, enhancing diagnostic accuracy.
- US cannot differentiate between vocal cord paralysis and immobilization.
Background:
The aim of the paper was to evaluate the usefulness of ultrasonographic examination in diagnosing laryngeal traumas, and monitoring the progress or complications in its treatment.
Material/Method:
In the years 2004-2009, 12 children, including 5 girls and 7 boys with laryngeal injuries, aged 5-12 years, were diagnosed and treated. In all the children, US examination of the neck and larynx, using a high-frequency linear transducer, as well as laryngoscopy and radiological examination of the cervical spine and chest were performed.
Results:
Blunt injury of the larynx was found in 12 children; in 9 children, the injury had been caused by hitting the neck against an obtuse object, 1 child had been kicked in the neck, and in one there had been an attempt of strangling. One of the children had sustained blunt injuries of the neck and chest in a traffic accident. IN US EXAMINATIONS, THE FINDINGS INCLUDED: unilateral lack of vocal cord mobility in 5 children, asymmetry in vocal cord mobility in 1 child, fractured thyroid cartilage with local hematoma in the affected area in 2 children, and thickened vocal cords in 5 children. IN RADIOLOGICAL EXAMINATION, THE FINDINGS INCLUDED: subcutaneous emphysema in the cervical area of the chest in 4 children, and mediastinal emphysema in 2 children with traumatic rupture of the trachea shown in laryngoscopy.
Conclusions:
US examination is helpful in the assessment of the extensiveness of laryngeal trauma, especially in the evaluation of vocal cord mobility, cervical cartilage and the soft tissues of the neck. A high level of conformity was demonstrated between the results of cervical US and the respective laryngoscopic findings. US examination does not allow to differentiate between vocal cord paralysis and their immobilization.
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