Laryngeal inhalational injuries: A systematic review

Area of Science:

• Otolaryngology
• Emergency Medicine
• Pulmonology

Background:

• Laryngeal inhalation injury is associated with high mortality and necessitates prompt airway assessment.
• Immediate intubation for airway management can exacerbate mucosal damage.
• Limited data exists on predictive factors and long-term outcomes of laryngotracheal injuries.

Purpose of the Study:

• To systematically review existing literature on inhalational injuries of the upper airway.
• To identify predictive factors and long-term sequelae of laryngeal inhalation injuries.
• To compare outcomes based on the timing of laryngeal injury diagnosis relative to airway intervention.

Main Methods:

• Systematic review of PubMed, Embase, and Cochrane databases.
• Inclusion of studies investigating inhalational injuries of the upper airway.
• Analysis of demographic data, presentation, physical findings, and delayed sequelae.

Main Results:

• Airway stenosis was significantly more common in patients intubated before laryngeal evaluation (50.0%) compared to those evaluated first (5.2%).
• Posterior glottic involvement occurred exclusively in patients intubated prior to airway assessment (71.4%).
• Thermal injuries in enclosed spaces were frequently associated with delayed laryngotracheal sequelae.

Conclusions:

• Laryngeal inhalational injuries represent a distinct clinical entity with potential for severe, delayed laryngotracheal complications.
• Early otolaryngology consultation may be vital for mitigating or treating these adverse effects.
• The timing of airway intervention relative to laryngeal injury diagnosis impacts patient outcomes.