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Lacerations of the cervical trachea in children
I H Kielmovitch1, W H Friedman
1Department of Pediatric Otolaryngology, Park Central Institute, Saint Louis, MO 63139.
Insights
Conservative management of small, well-approximated tracheal lacerations in children can be effective. This approach avoids tracheostomy complications and shortens hospital stays for pediatric patients with blunt neck trauma.
Area of Science:
- Pediatric Surgery
- Trauma Management
- Otolaryngology
Background:
- Cervical tracheal injuries from blunt neck trauma are rare in children.
- Tracheal lacerations typically necessitate immediate tracheostomy due to potential airway compromise.
Abstract:
Two case histories of a posterior tracheal laceration in children are presented. Both lacerations were small and well approximated at the time of initial endoscopy, and were managed conservatively. The resolution of signs and symptoms was rapid, and both patients were discharged after 4 days of hospitalization. Blunt trauma to the neck, not uncommon in children, is rarely a cause of cervical tracheal injury. When a tracheal laceration occurs, an immediate tracheostomy is usually recommended. Our experience supports a conservative management of small membraneous cervical trachea lacerations which seem well approximated at the time of endoscopy. Potential morbidity from tracheostomy is avoided, and the patient's hospitalization shortened.