This document discusses laryngeal injuries, including common causes such as automobile accidents, strangulation, and penetrating wounds. It outlines various types of injuries that can occur to laryngeal structures like fractures to the thyroid cartilage or hyoid bone. Symptoms including respiratory distress, pain with swallowing, and voice changes are described. The document provides guidance on evaluation of laryngeal injuries using tools like laryngoscopy and imaging. Treatment recommendations include steroid therapy, antibiotics, tracheostomy, open reduction and fixation of fractures, and laryngeal stenting. Potential complications from laryngeal trauma such as stenosis and vocal cord paralysis are also noted.

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11.  Chemical
 Thrermal
 Physical

12.  Automobile accidents
 Blow or kick on the neck.
 Striking against a stretched wire or cable.
 Strangulation.
 Penetrating injuries with
 Sharp instruments
 gunshot wounds

13.  Haematoma and oedema of
 Suprag lottic or subglottic region.
 Tears in laryngeal or pharyngeal mucosa leading
subcutaneous emphysema.
 Dislocation of cricoarytenoid joints
 Arytenoid
 Cartilage may be displaced anteriorly
 Dislocated
 Avulsed
 Dislocation of cricothyroid joint
 Recurrent laryngeal nerve paralysis
 traverses just behind this joint.
 Fractures of the hyoid bone

14.  Fractures of thyroid cartilage.
 Vertical
 Transverse.
 Fracture of upper part of thyroid cartilage
 May result in avulsion of epiglottis
 One or both false cords.
 Fractures of lower part of thyroid
 Displace or disrupt the true vocal cords.
 Fractures of cricoid cartilage.
 Fractures of upper tracheal rings.
 Trachea may separate from the cricoid
cartilage
 Retract into upper mediastinum
 Injury to recurrent laryngeal

15.  Respiratory distress.
 Hoarseness of voice or aphonia.
 Painful swallowing.
 Aspiration of food.
 Local pain in the larynx
 Marked on speaking
 Swallowing.
 Haemoptysis
 Tears in laryngeal or tracheal mucosa.

16.  Bruises or abrasions over the skin.
 Tenderness
 Subcutaneous emphysema due to mucosal tears
 Flattening of thyroid prominence
 Loss of contour of anterior cervical region.
 Thyroid notch may not be palpable
 Fracture displacements of thyroid or cricoid
 Fracture of hyoid bone.
 Gap may be felt between the fractured fragments.
 Bony crepitus
 Separation of cricoid cartilage from larynx or
trachea.

17.  Indirect laryngoscopy
 Direct laryngoscopy
 X-rays. Soft tissue
 CT scan

18.  Examine for other injuries like
 Injury to head
 Cervical spine
 Chest
 Abdomen and extremities.
 X-ray chest for pneumothorax
 Gastrograffin swallow for oesophageal
tears

19.  Patient should be hospitalised and observed
for
 Respiratory distress.
 Voice rest is essential.
 Humidification of inspired air is e en ria.
 Steroid therapy
 Immediatelly
 Full dose
 Reduce edeme
 Prevent scarring and stenosis.
 Antibiotics -
 Perichondritis and
 Cartilage necrosis.

20.  Tracheostomy
 Endotracheal intnbation
 Difficult
 Hazardous.
 Tracheostomy is preferred
 Open reduction
 3-5 days after injury
 Should not be delayed beyond 10 days.
 Fixation
 Wired
 Miniplates

21.  Mucosal lacerations repaired - catgut
 Loose fragments of cartilage removed.
 Epiglottis
 Anchored
 Excised.
 Arytenoid cartilages – repositioned
 Laryngotracheal separation,
 End to end anastomosis
 Lntemal splintage
 Laryngeal stent
 Silicone tube which - 2 to 6 weeks on an average ..
 Webbing
 Prevented by a silastic keel.

22.  Laryngeal stenosis,
 Supraglottic
 Glottic
 Subglottic.
 Perichondritis
 Laryngeal abscess.
 Vocal cord paralysis.

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