To understand the initial management of acute trauma to the neck and avoid life threatening airway obstruction. To recognise the classical presentation of laryngeal trauma and consider the proper investigations to diagnose an obstructing or haematoma laryngeal fracture.

Laryngeal trauma is a significant injury that has the potential to be life threatening due to airway obstruction. Laryngeal fractures represent 1% of blunt force trauma with the majority resulting from road traffic accidents or closeline injuries and a small proportion due to assault. Women and the elderly are more susceptible to the injury due to their long thin necks in the former and calcification in the latter. However, the injury is more common in men(70:30) due to sports or fighting related injury[1,2].

The three patient's in our series all presented to the emergency room following direct trauma to the neck region and complaining of related symptoms such as: hoarseness, dyspnoea, dysphonia, aphonia, dysphagia, odynophagia, or odynophonia. On physical examination, the most common signs related to laryngeal trauma include pain on palpation, haemoptysis, subcutaneous emphysema or stridor[3]. In the emergency department, Advanced Trauma Life Support(ATLS) protocol dictates securing the airway. This step is specifically important in the setting of suspected laryngeal trauma. Once immediate life-threatening injuries have been...

Laryngeal fracture is a significant injury that should be suspected in any patient that has suffered direct trauma to the neck region. Initial Advanced Trauma Life Support protocol should be followed to secure the patient's airway and exclude other life threatening injuries. Following ATLS, prompt recognition of classic signs and symptoms associated with neck trauma should lead the clinician to order appropriate radiological investigations, including cervical x-ray. Further investigations including a transnasal fiberoptic laryngoscopy and/or CT neck, can reveal an obstructing haematoma or fracture. The...

Joseph Sheehan, Department of Radiology, University Hospital Galway, Galway, Ireland

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