[Laryngeal trauma and laryngo-tracheal rupture during road accidents. Current concepts (author's transl)]

The authors review 6 cases of laryngeal trauma and 2 cases of laryngotracheal rupture which were seen after road accidents. They note that increasingly, as a result of the intervention of emergency medical ambulance teams, such injured patients are intubated at the site of the accident. Closed laryngo-tracheal rupture corresponds completely with cases described in the literature, forming a clinical picture which is a source of grave error by virtue of its latent nature. The management at the time of admission of the patient obviously is altered if intubation has already been performed, since the tube should never be removed for the purposes of clinical assessment before tracheotomy has been performed. If the patient is not intubated, the presence of respiratory distress necessitating emergency therapy reflect major lesions which therefore require surgical exploration. Rather than primary tracheotomy, the authors prefer intubation using a rigid bronchoscope which facilitates subsequent tracheotomy.