Clinical analysis of external laryngeal trauma

1994 ◽  
Vol 108 (3) ◽  
pp. 221-225 ◽  
Author(s):  
P. T. Yen ◽  
H. Y. Lee ◽  
M. H. Tsai ◽  
S. T. Chan ◽  
T. S. Huang
Keyword(s):  
Vocal Fold ◽  
Motor Vehicle ◽  
Clinical Analysis ◽  
Airway Patency ◽  
Laryngeal Trauma ◽  
Vehicle Accidents ◽  
Presenting Symptoms ◽  
Laryngeal Injury ◽  
Life Threatening ◽  
The Voice

AbstractThirty patients with external laryngeal trauma were analysed retrospectively. Injuries were mostly caused by motor vehicle accidents (car = 36.7 percent; motorcycle = 23.3 per cent). The main presenting symptoms and signs were hoarseness, neck tenderness, dysphagia, and neck emphysema. Sites of laryngeal injury included arytenoid swelling, vocal fold injury, soft tissue contusion or superficial mucosal laceration, cricoarytenoid dislocation, thyroid fracture, epiglottic fracture and mixed injuries. Treatment was varied depending on the severity of the injuries. Sixteen cases were managed conservatively by medical treatment; two cases received intubation; four cases were treated initially by tracheostomy; eight cases received surgical repair and/or reconstruction; 11 cases made a full recovery of the voice and 18 cases fair voice recovery due to either sustained vocal fold swelling or limitation of vocal fold movement. One case was graded as poor. Twenty-eight cases had good airway patency and two cases fair airway patency. A delay in the early detection of laryngeal trauma may precipitate into life-threatening airway problems, therefore prompt and accurate diagnosis should be followed immediately by skilful airway management.

Clinical Analysis of Laryngeal Trauma Secondary to Intubation

1983 ◽  
Vol 76 (11) ◽  
pp. 928-932 ◽  
Author(s):  
M J Gleeson ◽  
A J Fourcin
Keyword(s):  
Frequency Distribution ◽  
Vocal Fold ◽  
Clinical Analysis ◽  
Short Term ◽  
Frequency Distributions ◽  
Laryngeal Trauma ◽  
Disease States ◽  
Objective Evidence ◽  
The Voice ◽  
Insight Into

A study was undertaken to analyse the effect of short-term intubation on the voice. Children were examined laryngographically both pre- and postoperatively. Changes in larynx frequency distribution following intubation were documented using the technique of electrolaryngography; the resolution of these changes was similarly recorded. The results, in comparison with the frequency distributions associated with other disease states, give insight into the nature of the damage and its effect on vocal fold vibratory patterns. The technique therefore enables objective evidence of minor degrees of laryngeal trauma to be demonstrated and differentiated.

scholarly journals Laryngeal Trauma

2021 ◽  
Vol 29 (1) ◽  
pp. 86-93
Author(s):  
Gurbax Singh ◽  
Sumit Prinja ◽  
Suchina Parmar ◽  
Garima Bansal ◽  
Simmi Jindal
Keyword(s):  
Traffic Accidents ◽  
Surgical Intervention ◽  
Road Traffic ◽  
Penetrating Trauma ◽  
Laryngeal Trauma ◽  
Presenting Symptoms ◽  
Laryngeal Injury ◽  
Life Threatening ◽  
Term Basis ◽  
Specific Factors

Introduction Laryngeal trauma can be an immediately life-threatening entity.  Failure to recognize such injuries and delay in securing the airway may have fatal results. Early diagnosis and accurate evaluation with proper treatment is vital. Materials and Methods Fifteen patients with laryngotracheal injuries were analyzed prospectively. The outcome was assessed both in terms of voice and airway, on short term and long term basis. Result Commonest cause of injury was suicidal followed by road traffic accidents and strangulation. The main presenting symptoms and signs were stridor, hoarseness, haemoptysis and odynophagia. Five patients suffered penetrating trauma and ten patient sustained blunt trauma. Sites of laryngeal injury included; hyoid bone fracture, mixed soft tissue and cartilaginous injuries, thyrohyoid membrane and cricothyroid membrane injuries. Eleven patients presented within 24 hours of the injury. Outcome (airway and voice) was good in ten patients whereas it was poor in three patients. Poor results were seen in patients who had delayed surgical intervention. Conclusion Early surgical intervention is recommended for   traumatic laryngeal injuries to ensure a good outcome; which further depends upon patient’s condition, injury and treatment-specific factors.

scholarly journals Risk and resilience factors of persons exposed to accidents

2016 ◽  
Vol 89 (2) ◽  
pp. 257-266
Author(s):  
Dana - Cristina Herta ◽  
Paula Brindas ◽  
Raluca Trifu ◽  
Doina Cozman
Keyword(s):  
Motor Vehicle ◽  
Motor Vehicle Accidents ◽  
Risk And Resilience ◽  
Reasons For Living ◽  
Vehicle Accidents ◽  
Physical Suffering ◽  
Accident Victim ◽  
Life Threatening ◽  
Resilience Factors ◽  
Reasons For Living Inventory

Background and aims. Resilience encompasses factors promoting effective functioning in the context of adversity. Data regarding resilience in the wake of accidental trauma is still scarce. The aim of the current study is to comparatively assess adaptive, life – promoting factors in persons exposed to motor vehicle accidents (MVA) vs. persons exposed to other types of accidents, and to identify psychological factors of resilience and vulnerability in this context of trauma exposure.Methods. We assessed 93 participants exposed to accidents out of 305 eligible patients from the Clinical Rehabilitation Hospital and Cluj County Emergency Hospital. The study used Reasons for Living Inventory (RFL) and Life Events Checklist. Scores were comparatively assessed for RFL items, RFL scale and subscales in participants exposed to motor vehicle accidents (MVA) vs. participants exposed to other life – threatening accidents.Results. Participants exposed to MVA and those exposed to other accidents had significantly different scores in 7 RFL items. Scores were high in 4 out of 6 RFL subscales for both samples and in most items comprising these subscales, while in the other 2 subscales and in some items comprising them scores were low.Conclusions. Low fear of death, physical suffering and social disapproval emerge as risk factors in persons exposed to life – threatening accidents. Love of life, courage in life and hope for the future are important resilience factors after exposure to various types of life – threatening accidents. Survival and active coping beliefs promote resilience especially after motor vehicle accidents. Coping with uncertainty are more likely to foster resilience after other types of life – threatening accidents. Attachment of the accident victim to family promotes resilience mostly after MVA, while perceived attachment of family members to the victim promotes resilience after other types of accidents.  

Unilateral true vocal fold paralysis: Cause of right-sided lesions

2000 ◽  
Vol 122 (5) ◽  
pp. 678-680
Author(s):  
C. Anthony Hughes ◽  
Sven Troost ◽  
Susan Miller ◽  
Thomas Troost
Keyword(s):  
Vocal Fold ◽  
Vocal Fold Paralysis ◽  
Patient Records ◽  
Voice Pitch ◽  
Sex Distribution ◽  
Voice Analysis ◽  
Pitch Change ◽  
University Center ◽  
Presenting Symptoms ◽  
The Voice

At the Georgetown University Center for the Voice, 778 patients were referred for evaluation between July 1, 1990, and June 30, 1995. During this 5-year period, right true vocal fold paralysis or paresis was diagnosed in 24 of these patients (3%). Videostro-boscopy, voice analysis, and patient records were reviewed. Ages ranged from 23 to 80 years, and sex distribution approximated a 1:1 ratio. The patients presenting symptoms included hoarseness, dysphagia, choking, voice pitch change, voice weakness, fatigability, and breathiness. Sources of the vocal fold dysfunction included iatrogenic, traumatic, central, and infectious causes.

scholarly journals Shock Index as a Predictor for Angiographic Hemostasis in Life-Threatening Traumatic Oronasal Bleeding

2021 ◽  
Vol 18 (21) ◽  
pp. 11051
Author(s):  
Fang-Yu Hsu ◽  
Shih-Hsuan Mao ◽  
Andy Deng-Chi Chuang ◽  
Yon-Cheong Wong ◽  
Chih-Hao Chen
Keyword(s):  
Motor Vehicle ◽  
Early Recognition ◽  
Arterial Embolization ◽  
Maxillary Artery ◽  
Trauma Patients ◽  
Shock Index ◽  
Packed Red Blood Cells ◽  
Vehicle Accidents ◽  
Life Threatening ◽  
Craniofacial Trauma

The objective of this retrospective study was to identify predictors of angiographic hemostasis among patients with life-threatening traumatic oronasal bleeding (ONB) and determine the threshold for timely referral or intervention. The diagnosis of traumatic, life-threatening ONB was made if the patient suffered from craniofacial trauma presenting at triage with unstable hemodynamics or required a definitive airway due to ONB, without other major bleeding identified. There were 4404 craniofacial trauma patients between January 2015 and December 2019, of which 72 (1.6%) fulfilled the diagnosis of traumatic life-threatening ONB. Of these patients, 39 (54.2%) received trans-arterial embolization (TAE), 11 (15.3%) were treated with other methods, and 22 (30.5%) were excluded. Motor vehicle accidents were the most common cause of life-threatening ONB (52%), and the internal maxillary artery was the most commonly identified hemorrhaging artery requiring embolization (84%). Shock index (SI) was significantly higher in the angiographic hemostasis group (p < 0.001). The AUC-ROC was 0.87 (95% CI, 0.88–1.00) for SI to predict angiographic hemostasis. Early recognition and timely intervention are crucial in post-traumatic, life-threatening ONB management. Patients initially presenting with SI > 0.95 were more likely to receive TAE, with the TAE group having statistically higher SI than the non-TAE group whilst receiving significantly more packed red blood cells. Hence, for patients presenting with life-threatening traumatic ONB and a SI > 0.95, TAE should be considered if preliminary attempts at hemostasis have failed.

Unilateral True Vocal Fold Paralysis: Cause of Right-Sided Lesions

2000 ◽  
Vol 122 (5) ◽  
pp. 678-680 ◽  
Author(s):  
C. Anthony Hughes ◽  
Sven Troost ◽  
Susan Miller ◽  
Thomas Troost
Keyword(s):  
Vocal Fold ◽  
Vocal Fold Paralysis ◽  
Patient Records ◽  
Voice Pitch ◽  
Sex Distribution ◽  
Voice Analysis ◽  
Pitch Change ◽  
University Center ◽  
Presenting Symptoms ◽  
The Voice

At the Georgetown University Center for the Voice, 778 patients were referred for evaluation between July 1, 1990, and June 30, 1995. During this 5-year period, right true vocal fold paralysis or paresis was diagnosed in 24 of these patients (3%). Videostroboscopy, voice analysis, and patient records were reviewed. Ages ranged from 23 to 80 years, and sex distribution approximated a 1:1 ratio. The patients presenting symptoms included hoarseness, dysphagia, choking, voice pitch change, voice weakness, fatigability, and breathiness. Sources of the vocal fold dysfunction included iatrogenic, traumatic, central, and infectious causes.

scholarly journals Life‐threatening laryngeal injury in Elite Rugby Union: Prevention and management laryngeal trauma in rugby

2020 ◽  
Author(s):  
Bamidele Famokunwa ◽  
Simon Kemp ◽  
Julia Selby ◽  
Gitta Madani ◽  
Guri Sandhu ◽  
...  
Keyword(s):  
Rugby Union ◽  
Laryngeal Trauma ◽  
Laryngeal Injury ◽  
Life Threatening

Acute aortic syndrome: traumatic aortic injury

ESC CardioMed ◽  
2018 ◽  
pp. 2605-2606
Author(s):  
Johnny Steuer ◽  
Mario Lachat
Keyword(s):  
Life Support ◽  
Motor Vehicle ◽  
Expectant Management ◽  
Aortic Injury ◽  
Advanced Trauma Life Support ◽  
Trauma Patients ◽  
Vehicle Accidents ◽  
Life Threatening ◽  
Extent Of Damage ◽  
Intimal Tear

Blunt traumatic thoracic aortic injury (BAI) is a life-threatening emergency, the second most common cause of death in trauma patients, outnumbered only by intracranial haemorrhage. BAI is most frequently related to sudden deceleration in motor vehicle accidents, and the injury most commonly occurs at points of fixation in the descending aorta. In clinical series, it is predominantly in the region of the aortic isthmus. As victims of high-impact collisions often have multiple injuries, they are initially managed according to the Advanced Trauma Life Support® (ATLS®) concept. With improved pre- and in-hospital resuscitation, expeditious computed tomography angiography on arrival to the hospital, and increased awareness of the condition, patients who survive the initial impact are more likely to undergo successful treatment. All traumatic aortic injuries are not equally severe, as the extent of damage to the aortic wall may vary from an intimal tear to complete transection and rupture. Serial imaging and expectant management is advocated in patients with only an intimal tear but no external contour abnormality, whereas repair is recommended in most other cases. In recent years, thoracic endovascular aortic repair has emerged as the preferable treatment of patients with BAI, regardless of age. The initial outcome is highly dependent on the severity of other injuries, and most deaths are unrelated to the aortic injury per se, once the stent graft is in place. Long-term survival in patients discharged from the primary hospital admission is excellent. Early reintervention is fairly common, whereas late reinterventions are very uncommon.

Blunt abdominal aortic injury – A hybrid approach to combined injuries

2018 ◽  
Vol 2 (2) ◽  
Author(s):  
Ohad Guetta ◽  
Gad Shaked ◽  
George Greenberg ◽  
Gilbert Sebbag ◽  
David Czeiger
Keyword(s):  
Motor Vehicle ◽  
Seat Belt ◽  
Hybrid Approach ◽  
Aortic Injury ◽  
Stent Deployment ◽  
Early Management ◽  
Vehicle Accidents ◽  
Abdominal Aortic ◽  
Life Threatening ◽  
Seat Belt Injury

Blunt abdominal aortic injury (BAAI) is a relatively rare pathology, usually the result of a seat belt injury in motor vehicle accidents (MVA), mostly combined with other injuries. Time is a crucial factor for the successful early management of these cases. Hybrid operating theaters, which support the integration of surgical treatment and interventional radiology, provide opportunities to reduce the time-to-surgery for life threatening conditions. We report a case of a 24-year-old female who was involved in a high-kinematics MVA. On presentation she was hemodynamically stable but had a prominent seat belt sign and peritoneal signs. A computerized tomography (CT) scan revealed an intimal flap of the infra-renal aorta and a peri-aortic hematoma together with a suspected laceration of the small bowel. The patient was operated in a hybrid approach; emergent endovascular repair of the aortic injury with stent deployment immediately followed by an explorative laparotomy for the intestinal injury. Her postoperative course was uneventful. The hybrid staged approach allowed a clean and efficient repair of a potentially lethal aortic injury and addressing a contaminated injury in the same compartment, hence preventing redundant morbidity. With the advances and growing availability of endovascular techniques, the hybrid approach has to be an important component of trauma management in the modern era.

scholarly journals Blunt traumatic aortic injury: CT angiography images and short review of current literature

2021 ◽  
Vol 0 (Ahead of Print) ◽  
Author(s):  
Sok-Sithikun Bun ◽  
Duygu Ozgul ◽  
Yasin Guzel ◽  
Erol Aksungur
Keyword(s):  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Short Review ◽  
High Energy ◽  
Aortic Injury ◽  
Vehicle Accidents ◽  
Vehicle Accident ◽  
Threatening Condition ◽  
Life Threatening ◽  
Blunt Traumatic Aortic Injury

Blunt traumatic aortic injury in high-energy motor vehicle accidents is a rare but life-threatening condition. Proper treatment after prompt and accurate diagnosis is critical to reduce the death rate. The purpose of this article was to highlight the points to be considered in blunt traumatic aortic injury due to high-energy motor vehicle accident.

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