Injuries (trauma) to the larynx and trachea

Damage (injury) to the larynx and trachea, wounds to the larynx and trachea - damage that occurs as a result of direct or indirect impact on the organ of any object or substance.

ICD-10 code

• S10 Superficial injury of neck.
  • S10.0 Contusion of throat.
  • S10.1 Other and unspecified superficial injuries of throat.
  • S10.7 Multiple superficial injuries of neck.
  • S10.5 Superficial injury of other parts of neck.
  • S10.9 Superficial injury of unspecified part of neck.
• S11 Open wound of neck.
  • S11.0 Open wound involving larynx and trachea.
  • S27.5 Open wound of thoracic part of trachea.
  • S11.8 Open wound of other parts of neck.
• S14 Injury of nerves and spinal cord at cervical level.
  • S14.0 Contusion and oedema of cervical spinal cord.
  • S14.1 Other and unspecified injuries of cervical spinal cord.
  • S14.2 Injury of cervical nerve root.
  • S14.3 Injury of brachial plexus.
  • S14.4 Injury of peripheral nerves of neck.
  • S14.5 Injuries of cervical sympathetic nerves.
  • S14.6 Injury of other and unspecified nerves of neck.
• S15 Injury of blood vessels at neck level.
  • S15.0 Injury of carotid artery.
  • S15.1 Injury of vertebral artery.
  • S15.2 Injury of external jugular vein.
  • S15.3 Injury of internal jugular vein.
  • S15.7 Injury of multiple blood vessels at neck level.
  • S15.8 Injury of other blood vessels at neck level.
  • S15.9 Injury of unspecified blood vessel at neck level.
• S16 Injury of muscles and tendons at neck level.
• S17 Crushing injury of neck
  • S17.0 Crushing injury of larynx and trachea.
  • S17.8 Crushing of other parts
  • S17.9 Crushing injury of unspecified part of neck.
• S.18 Traumatic amputation at neck level.
• S19 Other and unspecified injuries of neck.
  • S19.7 Multiple injuries of neck.
  • S19.8 Other specified injuries of neck.
  • S19.9 Injury of neck, unspecified.

Epidemiology

The frequency of penetrating wounds with damage to the respiratory and digestive tracts, major vessels and nerve trunks is 5-10% of all peacetime injuries. Laryngeal injuries - 1 case per 25,000 visits for all types of injuries. In 30% of patients with penetrating wounds, the injuries are multiple. The overall mortality rate for penetrating wounds of the neck is 11%; for wounds accompanied by damage to large vessels - 66.6%.

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Causes trauma to the larynx and trachea

Trauma to the larynx and trachea may occur with a general neck injury. Causes of closed laryngotracheal injuries include a punch or object blow, car accidents, strangulation attempts, and blunt force trauma to the chest. Penetrating wounds are usually knife or bullet wounds. These are usually combined injuries.

Isolated injuries to the larynx and trachea occur with internal trauma. Internal trauma to the larynx and trachea is often iatrogenic (intubation, prolonged artificial ventilation). Injury to the larynx and trachea is possible with any manipulation of the larynx, including during endoscopic examinations and surgical interventions. Another cause of internal trauma to the larynx and trachea is the ingress of a foreign body (fish bone, parts of dentures, pieces of meat, etc.).

Damage (injuries) of the larynx and trachea - Causes and pathogenesis

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Symptoms trauma to the larynx and trachea

The severity of clinical manifestations depends on the degree of damage to the organs and structures of the neck, on the general condition of the patient, which is affected by the extent of the impact and the nature of the traumatic agent. The first and main symptom of traumatic damage to the larynx and trachea is respiratory dysfunction of varying severity. Respiratory failure can develop immediately after exposure to a traumatic factor or at a later date due to increasing edema, hematoma, tissue infiltration.

Dysphonia is typical for any damage to the larynx, especially its vocal section. Deterioration in voice quality can be sudden or gradual. In case of damage to the trachea or bilateral paralysis of the larynx with stenosis of the lumen, the vocal function suffers to a lesser extent.

Damage (injury) of the larynx and trachea - Symptoms

Diagnostics trauma to the larynx and trachea

Clarification of the time of injury, detailed characteristics of the traumatic agent and the mechanism of injury are important factors in assessing structural and functional damage to the hollow organs of the neck.

Physical examination includes a general examination and assessment of the patient's general somatic condition. When examining the neck, the nature of the injury and the condition of the wound surface are assessed, and hematomas are identified. Palpation of the neck allows one to determine the integrity of the larynx and trachea skeleton, areas of compaction, crepitus zones, the boundaries of which are noted in order to track the dynamics of emphysema or soft tissue infiltration. In case of penetrating wounds, probing of the wound canal is sometimes permissible. The manipulation must be carried out with great caution due to the possibility of causing additional iatrogenic injury.

Damage (injuries) of the larynx and trachea - Diagnostics

Screening

In most patients, clinical signs of traumatic injury to the larynx and trachea in the form of respiratory distress, neck pain, hoarseness, and skin hematomas are easy to diagnose. However, all patients, even without the above symptoms, who have suffered external neck, chest, or internal laryngeal and tracheal trauma of any etiology, should be examined for structural and functional damage to the hollow organs and soft tissues of the neck.

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Treatment trauma to the larynx and trachea

The probability of persistent structural changes and functional disorders in case of neck trauma is reduced with correct and timely assistance. Treatment methods used for larynx and trachea trauma depend on the timing, nature of the injury and the traumatic agent, the extent of damage to the organs and soft tissues of the neck, and the severity of the patient's condition.

Treatment tactics for open and closed injuries of the larynx and trachea are different. Open wounds and extensive injuries of the larynx with the development of an internal hematoma are the most dangerous in terms of the development of respiratory disorders and in most cases require surgical treatment.

Damage (injuries) of the larynx and trachea - Treatment