Anaesthetic management of acute laryngeal trauma

Three patients suffering acute laryngeal trauma illustrate problems of missed diagnosis and airway management confronting anaesthetists. A 55-year-old man suffered multiple injuries, including a supraglottic laryngeal fracture which was not diagnosed during administration of a subsequent general anaesthetic. The diagnostic delay compromised any reconstructive surgery. Two 26-year-old males suffered laryngeal fractures, but tracheal intubation for reconstruction and tracheostomy was successful. Guidelines for management are suggested.