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Operative Management of Vocal Fold Avulsion Following Pediatric Laryngotracheal Separation

Michael T Chang1, David W Schoppy1, Krista K Schoppy1

  • 1Department of Otolaryngology-Head and Neck Surgery, Stanford University, Stanford, CA, USA.

Ear, Nose, & Throat Journal
|September 28, 2019
PubMed

Insights

Severe laryngotracheal injuries in children, though rare, are life-threatening. Prompt diagnosis and surgical intervention are crucial for successful outcomes in pediatric blunt cervical trauma cases.

Area of Science:

  • Pediatric Otolaryngology
  • Trauma Surgery
  • Emergency Medicine

Background:

  • Laryngotracheal disruption and endolaryngeal injuries in children are uncommon but potentially fatal.
  • Blunt cervical trauma can cause severe internal airway damage that may be missed on initial assessment.

Observation:

  • A 10-year-old boy presented with near-complete laryngotracheal separation, laryngeal fractures, and vocal fold avulsion after blunt neck trauma.
  • Radiographic imaging failed to detect the extent of the endolaryngeal injuries, which were only discovered during surgery.

Findings:

  • Surgical repair of the severe laryngotracheal disruption was successful.
  • The patient achieved decannulation, resumed a normal diet, and regained a functional speaking voice within two months post-surgery.

Implications:

  • Severe endolaryngeal injuries in pediatric patients require a high index of clinical suspicion due to diagnostic challenges.
  • Accurate and timely surgical intervention is essential for favorable outcomes in pediatric laryngotracheal trauma.

Keywords:
airway stenosis/reconstructionpediatric airway (non-sleep) tracheaswallowing/dysphagiavoice

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