[Blunt trauma of the larynx: comparative assessment of computerized tomography, conventional radiology, and...

We report on the retrospective analysis of a series of 11 patients with blunt laryngeal injuries examined with Computed Tomography (CT), conventional radiology and laryngoscopy, to compare the diagnostic yield of each technique. Conventional frontal and lateral radiographs showed subcutaneous emphysema in 5 patients, with soft tissue swelling in 4, and thus failed to assess the degree of damage adequately. Cross-section CT showed cartilaginous injuries in 5 patients and adjacent soft tissue changes in 9, thus allowing rapid and accurate assessment of airway damage even in emergency. Laryngoscopy showed laryngeal mucosal tears in 3 patients, with decreased motion of the left true vocal cord in one patient and of both true vocal cords in another, associated with the upward dislocation of arytenoid cartilage. Moreover, laryngoscopy showed a mucosal tear in the hypopharynx in one patient. Comparative CT and laryngoscopy assessment showed, in two cases, that CT can demonstrate even minimal peripharyngeal and perilaryngeal air images which are suggestive of posttraumatic mucosal tears. Thus, CT appears the most valuable diagnostic tool to study the injured larynx.