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Laryngeal fracture after coughing
Mark Fenig1, Stephen Strasberg, Justin C Cohen
1Department of Emergency Medicine, Lincoln Medical and Mental Health Center, Bronx, NY.
The American Journal of Emergency Medicine
|June 29, 2013
Summary
Nontraumatic laryngeal fractures, specifically thyroid cartilage fractures, are rare. This case highlights a fracture caused by vigorous coughing, presenting with throat pain, difficulty swallowing, and voice changes.
Area of Science:
- Otolaryngology
- Trauma Surgery
- Medical Imaging
Background:
- Nontraumatic laryngeal fractures are exceptionally rare, with only three previous cases documented in medical literature.
- These fractures can occur spontaneously or due to minor trauma, often presenting diagnostic challenges.
Observation:
- A 47-year-old male experienced a thyroid cartilage fracture and phlegmon formation following a severe coughing episode.
- Symptoms included odynophagia, dysphagia, dysphonia, and localized swelling and tenderness over the thyroid cartilage.
Findings:
- Imaging (CT and MRI) confirmed a mildly displaced anterior thyroid cartilage fracture and adjacent phlegmon.
- Fiberoptic examination revealed edema of the aryepiglottic folds and arytenoid cartilages.
Implications:
- The triad of odynophagia, dysphagia, and dysphonia after forceful coughing or sneezing should prompt suspicion for thyroid cartilage fracture.
- Congenital abnormalities may predispose individuals to such rare fractures, necessitating careful evaluation.
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