International Conference  on Aesthetic Medicine and ENT

Biography

Biography: Lucio Maci

Abstract

Laryngeal trauma is an uncommon, diverse, and potentially

life threatening injury presenting acutely to the otolaryngologist. The most common associated injuries with laryngeal fractures are intracranial injuries , open neck injuries , cervical spine fractures  and esophageal injuries. Laryngeal fractures can be categorized as either penetrating or blunt injuries, which can be further categorized as either high or low velocity.] Most commonly, trauma to the larynx occurs as a result of a motor vehicle accident  or clothesline injury. A small percentage of causes include direct blows sustained during assaults, sport injuries, hanging, manual strangulation and iatrogenic causes.

The injury is uncommon due to protection of the larynx superiorly by the mandible (particularly when the head is flexed), inferiorly by the sternum and laterally by the SCM muscle.

Laryngeal trauma is often divided into two main groups—blunt trauma

and penetrating trauma. Laryngeal injuries vary by anatomical location : .

• Supraglottis
• Glottis: Traumatic force results in cruciate fractures of the thyroid cartilage near the attachment of the true vocal cords.
• Subglottis:
• Hyoid bone:
• Cricoarytenoid joint:
• Cricothyroid joint:
•  
• Complications include the following:

• Acute
  • Airway obstruction
  • Aphonia
  • Dysphonia
  • Odynophagia
  • Dysphagia
  • Postoperative complications (eg, hematoma, infection)
• Chronic
• Voice compromise
• Chronic obstruction
• Vocal cord injuries
• Fistula (tracheoesophageal, esophageal, or pharyngocutaneous)
• Cosmetic deformity
• Chronic aspiration
• Inability to decannulate

·         The overall outcome and prognosis of a patient with a laryngeal fracture depends on several factors, such as extent of injury, timing of repair, and the ability of the otolaryngologist to properly evaluate and treat the patient who has been traumatized. Generally, success is measured in terms of voice and airway function. Minor injuries usually result in return to preinjury airway and voice status. More significant trauma results in voice changes and requires more intensive procedures for airway stabilization.Object of our work are the laryngeal external trauma (open and closed) in various anatomical sites. They have highlighted the process of diagnosis and and especially the forensic investigation with particular reference to possible sequelae and their evaluation in terms of damage according to the italian legislation.