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Management of paediatric laryngotracheal trauma

Published online by Cambridge University Press:  05 July 2022

H Li
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital Affiliated to Capital Medical University, National Center for Children's Health, Beijing, China Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck Surgery, China
Z Li
Affiliation:
Department of Otolaryngology, Beijing First Hospital of Integrated Chinese and Western Medicine, China
J Zhao
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital Affiliated to Capital Medical University, National Center for Children's Health, Beijing, China Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck Surgery, China
G Wang
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital Affiliated to Capital Medical University, National Center for Children's Health, Beijing, China Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck Surgery, China
H Wang
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital Affiliated to Capital Medical University, National Center for Children's Health, Beijing, China Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck Surgery, China
F Zhang
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital Affiliated to Capital Medical University, National Center for Children's Health, Beijing, China Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck Surgery, China
N Sun
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital Affiliated to Capital Medical University, National Center for Children's Health, Beijing, China Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck Surgery, China
Y Han
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital Affiliated to Capital Medical University, National Center for Children's Health, Beijing, China Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck Surgery, China
J Zhang*
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital Affiliated to Capital Medical University, National Center for Children's Health, Beijing, China Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck Surgery, China
X Ni*
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital Affiliated to Capital Medical University, National Center for Children's Health, Beijing, China Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck Surgery, China
*
Authors for correspondence: Dr Jie Zhang and Xin Ni Department of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital Affiliated to Capital Medical University, National Center for Children's Health, Beijing 100045, China E-mail: [email protected] (Jie Zhang); [email protected] (Xin Ni) Fax: +86 10 5961 6393
Authors for correspondence: Dr Jie Zhang and Xin Ni Department of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital Affiliated to Capital Medical University, National Center for Children's Health, Beijing 100045, China E-mail: [email protected] (Jie Zhang); [email protected] (Xin Ni) Fax: +86 10 5961 6393

Abstract

Objective

To summarise and describe the clinical presentations, diagnostic approaches and airway management techniques in children with laryngotracheal trauma.

Methods

The clinical data related to laryngotracheal trauma diagnosed and treated at the Beijing Children's Hospital, between January 2013 and July 2018, were retrospectively reviewed. Disease diagnosis, treatment, management and outcomes were analysed.

Results

A total of 13 cases were enrolled, including 7 cases of penetrating laryngotracheal trauma. The six cases of blunt laryngotracheal trauma were caused by collisions with hard objects. In all cases, voice, airway and swallowing outcomes were graded as ‘good’, except for one patient who had residual paralysis of the vocal folds.

Conclusion

Flexible fibre-optic laryngoscopy and computed tomography can play an important role in diagnosing laryngotracheal trauma. The airway should be secured and, if necessary, opened by tracheal intubation or tracheostomy.

Type
Main Article
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Dr J Zhang takes responsibility for the integrity of the content of the paper

*

Hongbin Li and Zhuo Li contributed equally to this work.

References

Schaefer, SD. The acute management of external laryngeal trauma. A 27-year experience. Arch Otolaryngol Head Neck Surg 1992;118:598604CrossRefGoogle ScholarPubMed
Lee, WT, Eliashar, R, Eliachar, I. Acute external laryngotracheal trauma: diagnosis and management. Ear Nose Throat J 2006;85:179–84CrossRefGoogle ScholarPubMed
Chatterjee, D, Agarwal, R, Bajaj, L, Teng, SN, Prager, JD. Airway management in laryngotracheal injuries from blunt neck trauma in children. Paediatr Anaesth 2016;26:132–8CrossRefGoogle ScholarPubMed
Schaefer, SD. Management of acute blunt and penetrating external laryngeal trauma. Laryngoscope 2014;124:233–44CrossRefGoogle ScholarPubMed
Cheng, J, Cooper, M, Tracy, E. Clinical considerations for blunt laryngotracheal trauma in children. J Pediatr Surg 2017;52:874–80CrossRefGoogle ScholarPubMed
Sidell, D, Mendelsohn, AH, Shapiro, NL, St John, M. Management and outcomes of laryngeal injuries in the pediatric population. Ann Otol Rhinol Laryngol 2011;120:787–95CrossRefGoogle ScholarPubMed
Wootten, CT, Bromwich, MA, Myer, CM 3rd. Trends in blunt laryngotracheal trauma in children. Int J Pediatr Otorhinolaryngol 2009;73:1071–5CrossRefGoogle ScholarPubMed
Gold, SM, Gerber, ME, Shott, SR, Myer, CM 3rd. Blunt laryngotracheal trauma in children. Arch Otolaryngol Head Neck Surg 1997;123:83–7CrossRefGoogle ScholarPubMed
Moonsamy, P, Sachdeva, UM, Morse, CR. Management of laryngotracheal trauma. Ann Cardiothorac Surg 2018;7:210–16CrossRefGoogle ScholarPubMed
Jalisi, S, Zoccoli, M. Management of laryngeal fractures – a 10-year experience. J Voice 2011;25:473–9CrossRefGoogle ScholarPubMed
Breysem, L, Loyen, S, Boets, A, Proesmans, M, De Boeck, K, Smet, MH. Pediatric emergencies: thoracic emergencies. Eur Radiol 2002;12:2849–65CrossRefGoogle ScholarPubMed
Ford, HR, Gardner, MJ, Lynch, JM. Laryngotracheal disruption from blunt pediatric neck injuries: impact of early recognition and intervention on outcome. J Pediatr Surg 1995;30:331–4; discussion 334–5CrossRefGoogle Scholar
Kiser, AC, O'Brien, SM, Detterbeck, FC. Blunt tracheobronchial injuries: treatment and outcomes. Ann Thorac Surg 2001;71:2059–65CrossRefGoogle ScholarPubMed
Verschueren, DS, Bell, RB, Bagheri, SC, Dierks, EJ, Potter, BE. Management of laryngo-tracheal injuries associated with craniomaxillofacial trauma. J Oral Maxillofac Surg 2006;64:203–14CrossRefGoogle ScholarPubMed
O'Mara, W, Hebert, AF. External laryngeal trauma. J La State Med Soc 2000;152:218–22Google ScholarPubMed
Mathisen, DJ, Grillo, H. Laryngotracheal trauma. Ann Thorac Surg 1987;43:254–62CrossRefGoogle ScholarPubMed
Parida, PK, Kalaiarasi, R, Alexander, A. Management of laryngotracheal trauma: a five-year single institution experience. Iran J Otorhinolaryngol 2018;30:283–90Google ScholarPubMed
Shires, CB, Preston, T, Thompson, J. Pediatric laryngeal trauma: a case series at a tertiary children's hospital. Int J Pediatr Otorhinolaryngol 2011;75:401–8CrossRefGoogle Scholar
Oosthuizen, JC. Paediatric blunt laryngeal trauma: a review. Int J Otolaryngol 2011;2011:183047CrossRefGoogle ScholarPubMed
Hackett, AM, Chi, D, Kitsko, DJ. Patterns of injury and otolaryngology intervention in pediatric neck trauma. Int J Pediatr Otorhinolaryngol 2012;76:1751–4CrossRefGoogle ScholarPubMed
de Alarcon, A, Rutter, MJ. Revision pediatric laryngotracheal reconstruction. Otolaryngol Clin North Am 2008;41:959–80CrossRefGoogle ScholarPubMed