Hypopharyngeal injury as a result of attempted endotracheal intubation

Perforation of the hypopharynx due to traumatic attempted endotracheal intubation usually occurs during resuscitation efforts under poor conditions, but may occur even under optimal conditions due to improper technique. The implication of the appearance of subcutaneous emphysema in the neck, cyanosis, or pneumothorax during or following attempts at endotracheal intubation should be known. Direct laryngoscopy may be helpful in establishing the injury but early radiological examination is necessary for diagnosis of the site and extent of the perforation. The radiological contribution appears to be decisive in the choice of treatment. The radiological findings and the considerable morbidity observed in 6 cases of hypopharyngeal injury are described.