Mohammad Zafar Rabbani, Danyal Rashid, Amer Majeed.
Blunt, External Laryngeal Trauma, Clinical Analysis & Management, Experience at Combined Military Hospital, Rawalpindi.
Pak J Otolaryngol Jan ;18(2):23-5.

18 cases of external laryngeal trauma are being analyzed retrospectively. Main etiological factors were road traffic accidents 11 cases (61.11%) accidental strangulation 3 cases (16.66%), blunt trauma due to fall 1 case (5.5%) during fight 2 cases (11.11%) and suiccidal attempt 1 case (5.55%). Most of the patients presented with hoarseness or aphonia 8 cases (44.44%), pain and tenderness of neck 6 cases (33.33%), odynophagia 6 cases (33.33%) and swelling of the neck one case (5.55%). After careful history, meticulous examination and detailed investigations patients were grouped according to clinical findings. Group one had 4 patients having supraglottic swelling, edema, ore stenosis occurs as a squalal of lalpferl trauma ad occurs after sometime, not immediatily after trauma hamatoma (22.22%), group two had six patients having supraglottic stenosis (33.33%) group three had subglottic stenosis. Number of patients was again 6 (33.33%). Group four had two patients having subglottic stenosis and tracheal stenosis (11.11%). Treatment was varied depending upon the severity of the injuries. Fourpatients (22.22%) were managed by tracheostomy and conservative measures i.e., voice rest, humidification and bed rest. Fourpatients (22.22%) underwent laryngotracheal reconstruction with hyoid descent, three patients (16.66%) had suprahyoid release, resection and reanastomosis of stenotic segment. Two patients (11.11%) had laser ablation, two patients (11.11%) had laser ablation and serial dilations and one patient (5.55%) had laryngotracheal reconstruction with hyoid descent and augmentation with septal cartilage. Three patients (16.66%) underwent more than one operation. Fifteen patients out of eighteen (83.33%) recovered un-eventfully having stable air way, voice capable of verbal communication, decannulation and swallowing without aspiration, two patients (11.11 %) are still not decannulated and are declared unsuccessful, one patient (5.55%) has got left vocal cord paralysis. A delay in early detection of external laryngeal trauma may precipitate life threatening airway compromise later on, therefore prompt and accurate diagnosis should immediately be followed by skillful air way management.

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