Background: Penetrating neck injuries with laryngeal trauma is uncommon event which can lead to its damage and might cause mortality as well. The incidence of this type of laryngeal trauma increases in war times and areas of conflicts. Different modes of management are recommended depending on the presentation, site and nature of the injury. Case Report: We present this case of a 35 year old male who was exposed to shell injury of the larynx, documented by plain x-ray and CT scan of the neck; and managed by open exploration where midline thyrotomy with removal of the shell were done. Patient had a good recovery and an uneventful follow up period. Conclusion: Causes and incidence of penetrating laryngeal trauma differ between peace and war times. Early recognition and management is required to establish sufficient airway and to secure the patient's life if endangered. Management differs largely depending on the patient's presentation, site of trauma and the nature of the traumatic agent and its velocity.
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