No abstract

No abstract

The popularity of the motorcycle, specifically trail bike riding, in the past several years has produced an increasing incidence of severe "clothesline" injuries to the larynx and trachea. Even at moderately high speed the impact of a horizontal cable with the neck of the rider causes a sudden hyperextension of the neck, and an avulsion of the larynx from the trachea, separating at the relatively rigid fibrous connective tissue between the cricoid cartilage and the first tracheal ring. Interruption of the strap muscles, the recurrent laryngeal nerves, laceration of the esophagus, and compression fracture of the cervical vertebral bodies can occur. The unseated rider requires immediate assistance, airway obstruction being his greatest problem. In the early minutes after the accident he must be transported to an emergency facility where tracheostomy and resuscitation can be provided. Mediastinal infection, tracheoesophageal fistula, subglottic stenosis, and intermittent depression many follow the initial repair. Rehabilitative measures include permanent tracheostomy, the use of neuromuscular pedicle graft, hyoid bone graft, intracordal injection of teflon paste, and carbon dioxide laser excision of webs and cicatricial tissue.

Isolated uvulitis is a rarely reported disease. Known etiologies include bacterial infection and trauma following the use of instrumentation in the airway. Three cases of isolated uvulitis secondary to heavy marijuana smoke inhalation are reported. Specific recommendations regarding diagnosis and treatment of this disorder are made.