Epidemiology, Clinical Presentations and Radiologic Findings of Blunt Laryngeal Trauma

Background: External laryngeal trauma is rare. It has a population incidence of 1 in 137,000 in adults. In developing countries blunt trauma is more common than penetrating trauma. Blunt trauma may occur due to accidents, sports injuries or hanging. Laryngeal trauma manifests as a spectrum of symptoms and signs ranging from cardiopulmonary arrest to subtle changes in voice quality. The most common presenting feature of laryngeal trauma is hoarseness, followed by dysphagia and pain. Although blunt laryngeal trauma is rare, but it can be life threatening. So, its early and proper management will remarkably affect the immediate probability of patient’s survival and their long term quality of life.

Methods: In this cross-sectional and descriptive study, medical records of 30 patients with blunt laryngeal trauma, who were admitted in ENT ward of Imam Reza hospital over a 10-year period, were evaluated.

Results: 30 patients, including 27 (90%) males and 3 (10%) women were studied. Mean age of patients was 36.13±10.53 years. The most common cause of blunt laryngeal trauma was vehicle accidents. The most common presenting symptoms were neck pain and tenderness. Subcutaneous emphysema was the most common radiological finding. The most common laryngoscope findings were swelling and hematoma of true vocal cords. Treatment modalities were supportive therapy performed on 26(86.7%) patients, tracheotomy on 3(10%) patients and open surgery on 1(3.3%) patients. Also 2 (6.7%) patients required intubation.

Conclusion: In most patients suffering from mild trauma, conservative therapy is mostly administered. Any delay in early and proper diagnosis and treatment may be life threatening. So in such situations the patient's airway should be evaluated by skillful experts and emergency procedures have to be applied. Also any changes in patient's signs should be monitored frequently and the required diagnostic and therapeutic procedures must be applied.