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Ann Thorac Surg 1987;43:254-262
© 1987 The Society of Thoracic Surgeons

Articles

Laryngotracheal Trauma

Douglas J. Mathisen, M.D.*, Hermes Grillo, M.D.

From the General Thoracic Surgical Unit and Trauma Service, Massachusetts General Hospital, and the Department of Surgery, Harvard Medical School, Boston, MA

* Address reprint requests to Dr. Mathisen, Warren 1109, Massachusetts General Hospital, Boston, MA 02114

Laryngotracheal trauma can be an immediately life-threatening injury. Failure to recognize such injuries and promptly secure an airway may have fatal consequences. Failure to recognize acute injuries or to observe the principles of management can lead to laryngotracheal stenosis.

We have seen 10 patients with acute injuries. Blunt trauma was responsible in 5, penetrating trauma in 4, and iatrogenic injury in 1. Esophageal transection was present in 1 patient. Thoracotomy was required in 2 patients with injury of the carina, and cervical exposure was adequate in 8. All patients underwent successful repair of the injuries.

Seventeen patients have been treated for delayed traumatic laryngotracheal stenosis. Vocal cord paralysis was apparent in 14. Concomitant esophageal injury was repaired in 4 patients. Eight patients required intralaryngeal procedures prior to repair of the laryngotracheal stenosis. All patients except 1 have a good airway, and 16 of the 17 have a good voice.




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