Damage (trauma) of the larynx and trachea

Lesions (traumas) of the larynx and trachea, injuries of the larynx and trachea - damage that occurs as a result of direct or indirect effects on the body of an object or substance.

ICD-10 code

• S10 Surface trauma to the neck.
  • S10.0 Throat injury.
  • S10.1 Other and unspecified surface trauma to the throat.
  • S10.7 Multiple superficial injuries of the neck.
  • S10.5 Superficial injury of other parts of the neck.
  • S10.9 Superficial injury of the unspecified part of the neck.
• S11 Open neck wound.
  • S11.0 An open wound that affects the larynx and trachea.
  • S27.5 An open wound of the thoracic part of the trachea.
  • S11.8 Open wound of other parts of the neck.
• S14 Trauma of nerves and spinal cord at the level of the neck.
  • S14.0 Concussion and edema of the cervical spinal cord.
  • S14.1 Other and unspecified lesions of the cervical spinal cord.
  • S14.2 Trauma of the nerve root of the cervical spine.
  • S14.3 Injury of the brachial plexus.
  • S14.4 Injury of the peripheral nerves of the neck.
  • S14.5 Injuries to the sympathetic nerves of the cervical region.
  • S14.6 Injury of other and unspecified nerves of the neck.
• S15 Injury of blood vessels at the neck level.
  • S15.0 Trauma of the carotid artery.
  • S15.1 Injury of the vertebral artery.
  • S15.2 Injury of external yurary vein.
  • S15.3 Injury of the internal vaginal vein.
  • S15.7 Injury of several blood vessels at the neck level.
  • S15.8 Injury of other blood vessels at the neck level.
  • S15.9 Injury of unspecified blood vessel at neck level.
• S16 Injury of muscles and tendons at the level of the neck.
• S17 Crushing injury of the neck
  • S17.0 Crushing injury of the larynx and trachea.
  • S17.8 Crushing of other parts
  • S17.9 Crushing of the unspecified part of the neck.
• S.18 Traumatic amputation at the neck level.
• S19 Other and unspecified neck injuries.
  • S19.7 Multiple injuries of the neck.
  • S19.8 Other specified neck injuries.
  • S19.9 Neck injury, unspecified.

Epidemiology

The frequency of penetrating wounds with damage to the respiratory tract and digestive tract, trunk vessels and nerve trunks is 5-10% of all wounds in peacetime. Lesions of the larynx - 1 case for 25,000 calls for all types of injuries. In 30% of patients with penetrating wounds, the lesions are multiple. The total mortality for penetrating wounds of the neck is 11%; In injuries accompanied by damage to large vessels, 66.6%.

[1], [2], [3], [4], [5], [6]

Causes of the traumas of larynx and trachea

Trauma of the larynx and trachea can occur with a general neck injury. Causes of closed laryngotracheal injuries - punch or an object, auto-trauma, attempts of strangulation, a dull blow to the chest. Penetrating wounds are usually knife or bullet. As a rule, these are combined injuries.

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

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

[7], [8], [9]

Symptoms of the traumas of larynx and trachea

The severity of clinical manifestations depends on the degree of damage to the organs and structures of the neck, the general condition of the patient, which is affected by the vastness of the impact and the nature of the traumatic agent. The first and the main symptom of traumatic injury of the larynx and trachea is a violation of the function of respiration of different severity. Respiratory failure can develop immediately after the impact of the traumatic factor or in later periods due to the increase in edema, hematoma, and tissue infiltration.

Dysphonia is typical for any damage to the larynx, especially its voice department. The deterioration in the quality of the voice can be sudden or gradual. If the trachea is damaged or bilateral paralysis of the larynx with stenosis of the lumen, the voice function suffers less.

Lesions of the larynx and trachea - Symptoms

Diagnostics of the traumas of larynx and trachea

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

A physical examination includes communities examining and assessing the patient's overall medical condition. When examining the neck, evaluate the nature of the lesion and the condition of the wound surface, reveal hematomas. Palpation of the neck allows to determine the safety of the larynx and trachea skeleton, compaction sites, crepitus zones, the boundaries of which are marked for the purpose of tracking the dynamics of emphysema or infiltration of soft tissues. With penetrating wounds in a number of cases, it is permissible to probe the wound channel. Manipulation should be carried out with great care because of the possibility of additional iatrogenic injury.

Lesions of the larynx and trachea - Diagnosis

Screening

In most patients, the clinical signs of traumatic damage to the larynx and trachea in the form of breathing disorders, pain in the neck, hoarseness and cutaneous hematomas are easy to diagnose. However, all patients, even without the above symptoms, suffered an external trauma to the neck. Chest or internal trauma of the larynx and trachea of any etiology, it is necessary to examine for structural and functional damage of the hollow organs and soft tissues of the neck.

[10], [11], [12], [13]

Treatment of the traumas of larynx and trachea

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

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

Damage (trauma) of the larynx and trachea - Treatment