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Tracheal tear from blunt neck trauma in children: Diagnosis and management
David J Mener1, Fray Dylan Stewart2, David E Tunkel1
1Department of Otolaryngology - Head & Neck Surgery, Division of Pediatric Otolaryngology, The Johns Hopkins University School of Medicine, Baltimore, MD, United States.
Insights
This study presents two pediatric cases of posterior trachea tears from blunt neck trauma. Management varied from conservative intubation to surgical repair, depending on tear size and severity.
Area of Science:
- Pediatric Surgery
- Trauma Management
- Respiratory Tract Injuries
Background:
- Blunt neck trauma can cause posterior trachea tears, a rare but serious injury in children.
- Understanding the mechanism and optimal management is crucial for pediatric trauma care.
Observation:
- A 5-year-old boy with a 1.0cm cervical trachea tear was managed conservatively with intubation.
- A 12-year-old girl with a 4.0cm thoracic trachea tear underwent thoracoscopic repair.
Findings:
- The presumed mechanism involves expansion of tracheal cartilage leading to membranous tear.
- Treatment decisions for posterior trachea tears depend on tear size, location, and symptom severity.
Implications:
- This case series highlights the spectrum of management options for pediatric posterior trachea tears.
- Tailoring treatment based on injury characteristics is key to successful outcomes in pediatric airway trauma.
Abstract:
We describe the management of posterior trachea tears after blunt neck trauma in two children. The first, a 5 year-old boy who fell off his scooter, causing a 1.0cm tear in the membranous cervical trachea, was managed conservatively with 5 days of intubation. The second, a 12 year-old girl who fell on her bicycle, causing a 4.0cm tear in the membranous thoracic trachea, was repaired with thoracoscopic techniques. The presumed mechanism may be expansion of the U-shaped cartilage with tear of the membranous trachea. The size, location, and severity of symptoms dictate the decision about primary repair versus conservative management.