PDF(Pubmed)
Abstract：
OBJECTIVE: External laryngotracheal trauma (ELT), blunt or penetrating, is a rare but potentially life-threatening injury. Immediate care in the emergency department can be challenging because it requires managing a potentially unstable airway and may have associated vascular injuries with massive bleeding. Here, we look at the details of injury, treatment measures, and outcomes in patients following ELT.
METHODS: We retrospectively analyzed 22 patients treated at our center for ELT from January 2005 up to December 2021 with varying grades of injury. We looked at their status at presentation, management strategy and functional status.
RESULTS: In our report, we include 18 men and 4 women having varying Schaefer injury grades. Eight patients had tracheostomy at presentation and eight had vocal fold immobility. Two patients were treated endoscopically, 12 had open surgery and 8 received no treatment. Of the patients undergoing open surgery, thyroid cartilage fracture was seen in 9 patients, thyroid plus cricoid fracture and cricotracheal separation were seen in 3 patients each. All patients were safely decannulated and spontaneous recovery of vocal cord palsy was seen in some patients.
CONCLUSIONS: The success of managing ELT relies on fast decision-making, correct patient evaluation, securing the airway and maintaining the hemodynamic stability. Early surgical intervention must be aimed at optimally treating the larygotracheal injuries to prevent long-term disastrous consequences.
METHODS: We retrospectively analyzed 22 patients treated at our center for ELT from January 2005 up to December 2021 with varying grades of injury. We looked at their status at presentation, management strategy and functional status.
RESULTS: In our report, we include 18 men and 4 women having varying Schaefer injury grades. Eight patients had tracheostomy at presentation and eight had vocal fold immobility. Two patients were treated endoscopically, 12 had open surgery and 8 received no treatment. Of the patients undergoing open surgery, thyroid cartilage fracture was seen in 9 patients, thyroid plus cricoid fracture and cricotracheal separation were seen in 3 patients each. All patients were safely decannulated and spontaneous recovery of vocal cord palsy was seen in some patients.
CONCLUSIONS: The success of managing ELT relies on fast decision-making, correct patient evaluation, securing the airway and maintaining the hemodynamic stability. Early surgical intervention must be aimed at optimally treating the larygotracheal injuries to prevent long-term disastrous consequences.
摘要：
目的：喉气管外伤（ELT），钝的或穿透的，是一种罕见但可能危及生命的伤害.急诊科的即时护理可能具有挑战性，因为它需要管理潜在的不稳定气道，并且可能会导致血管损伤和大量出血。这里,我们看看受伤的细节，处理措施,和ELT后患者的结果。
方法：我们回顾性分析了从2005年1月至2021年12月在我们的ELT中心接受治疗的22例不同程度的损伤患者。我们看了他们在演讲中的状态，管理策略和职能地位。
结果：在我们的报告中，我们包括18名男性和4名女性，他们有不同的Schaefer损伤等级。八名患者在就诊时进行了气管造口术，八名患者声带不活动。两名患者接受了内镜治疗，12例进行了开放性手术，8例未接受治疗。在接受开放手术的病人中，9例患者出现甲状软骨骨折,甲状腺伴环状突骨折和环气管分离各3例。所有患者均安全拔管，部分患者出现声带麻痹自发恢复。
结论：管理ELT的成功依赖于快速决策，正确的患者评估，固定气道并保持血流动力学稳定。早期手术干预必须旨在最佳治疗幼鱼气管损伤，以防止长期灾难性后果。
方法：我们回顾性分析了从2005年1月至2021年12月在我们的ELT中心接受治疗的22例不同程度的损伤患者。我们看了他们在演讲中的状态，管理策略和职能地位。
结果：在我们的报告中，我们包括18名男性和4名女性，他们有不同的Schaefer损伤等级。八名患者在就诊时进行了气管造口术，八名患者声带不活动。两名患者接受了内镜治疗，12例进行了开放性手术，8例未接受治疗。在接受开放手术的病人中，9例患者出现甲状软骨骨折,甲状腺伴环状突骨折和环气管分离各3例。所有患者均安全拔管，部分患者出现声带麻痹自发恢复。
结论：管理ELT的成功依赖于快速决策，正确的患者评估，固定气道并保持血流动力学稳定。早期手术干预必须旨在最佳治疗幼鱼气管损伤，以防止长期灾难性后果。
