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Blunt laryngeal trauma presenting as bilateral massive pneumothoraces and subcutaneous emphysema: a multidisciplinary

Christopher W Noel1, Suneel Kumar Pooboni2, Gamal Metwalli Metwalli2

  • 1Otolaryngology - Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada christopher.noel@mail.utoronto.ca.

BMJ Case Reports
|April 3, 2020
PubMed

Insights

A child sustained blunt laryngeal trauma after a fall, developing swelling and respiratory distress. Prompt management and a watchful waiting approach led to successful extubation and recovery with a clear voice.

Area of Science:

  • Pediatric Emergency Medicine
  • Trauma Surgery
  • Otolaryngology

Background:

  • Blunt laryngeal trauma is a rare but serious injury in children.
  • High-energy mechanisms, such as falls from heights, can cause significant neck trauma.

Observation:

  • A 3-year-old boy experienced an unwitnessed fall from a highchair, presenting with rapid neck and facial swelling.
  • Initial symptoms included rapid deterioration requiring intubation, with a clinical diagnosis of blunt laryngeal trauma.

Findings:

  • Imaging revealed massive bilateral pneumothoraces, managed with chest tubes, but no laryngeal disruption.
  • A multidisciplinary team adopted a watchful waiting strategy for the laryngeal injury.

Implications:

  • This case highlights the importance of thorough trauma assessment in pediatric falls.
  • Conservative management can be successful in select cases of blunt laryngeal trauma with associated pneumothoraces.
  • Early recognition and multidisciplinary collaboration are crucial for optimal outcomes in pediatric airway emergencies.

Keywords:
ear, nose and throatear, nose and throat/otolaryngologyemergency medicinetrauma

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