Multidetector Row Computed Tomography of the Injured Larynx After Trauma

Robinson, Andrew; Juutilainen, Marko; Suomalainen, Anni; Mäkitie, Antti

doi:10.1053/j.sult.2009.02.002

Cited by 18 publications

(9 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although features detected on CT may provide some guidance, nonindicated early intubation is a significant issue in patients with ELTIs because it eliminates many of the clinical injury features that assist a surgeon in deciding to proceed with early operative intervention and, as a result, optimize both vocal and aerodigestive outcomes. 19,20 Fig . 6 shows a simplified algorithm applicable to the management of ELTIs in the trauma assessment.…”

Section: Discussionmentioning

confidence: 99%

Airway management changes associated with rising radiologic incidence of external laryngotracheal injury

Randall

Rudmik

Ball³

et al. 2018

cjs

View full text Add to dashboard Cite

Background: Traumatic laryngeal injuries are uncommon life-threatening injuries that require prompt, rational management of a potentially precarious airway. It is unclear whether the current incidence of laryngotracheal injury is due to enhanced injury detection or increased occurrence. The objective of this study was to evaluate the relations between diagnostic imaging with both initial airway management and surgical treatment in patients with external laryngotracheal injuries (ELTIs) in Alberta. Methods:In this large-scale population-based analysis, we used regional health databases containing inpatient admissions, emergency department visits and trauma service activations employing International Classification of Diseases diagnostic codes to identify all ELTIs diagnosed from Apr. 1, 1995, to Dec. 31, 2011, in adults (age ≥ 16 yr). We evaluated health records and diagnostic imaging for injury features, airway management, operative interventions and hospital length of stay (LOS).Results: Eighty-nine patients met the inclusion criteria. The incidence of ELTIs increased over time, paralleling a rise in detection during the period incorporating greater computed tomography (CT) use (p = 0.002). Endotracheal tube intubation was performed in 8/30 cases (27%) in the pre-CT era, compared to 38/59 cases (64%) in the post-CT era (p = 0.001); the use of surgical intervention remained consistent. The largest contributors to increased endotracheal tube placements were the emergency department and emergency medical services. No change in survival was detected, but mean LOS among patients admitted for minor, isolated ELTIs increased by 2.3 (95% confidence interval 0.14-4.8) days (p = 0.06), mostly for patients admitted under critical care for mechanical ventilation. Conclusion:Management of ELTIs shifted from predominantly conservative airway monitoring to endotracheal tube intubation over the study period in spite of no clinically significant change in injury severity or operative intervention frequency. The location of endotracheal tube placement suggests less comfort with ELTI among first-responder and emergency personnel.

show abstract

Section: Discussionmentioning

confidence: 99%

Airway management changes associated with rising radiologic incidence of external laryngotracheal injury

Randall

Rudmik

Ball³

et al. 2018

cjs

View full text Add to dashboard Cite

show abstract

“…The thyroid cartilage is the most often fractured, followed by cricoid and arytenoid fractures. 16 Vertical fractures result from a splaying force on the thyroid cartilage when pressed against the spine (Fig 4). In adults, thyroid cartilage fractures are typically horizontally oriented with both alae affected, whereas in children, fractures are frequently vertical with midline or paramedian orientations.…”

Section: Anatomy and Pathology Of The Thyroid Cartilagementioning

confidence: 99%

“…Unfortunately, it would be extremely unusual to image patients with grade V injuries-those with cricotracheal separation-due to the usually lethal nature of these injuries. 16 A significant number of patients may have laryngeal injury without associated clinical symptoms or signs. These injuries are often visible on CT examinations performed for other indications, such as on cervical spine CT or CT angiography.…”

Section: Role Of Imagingmentioning

confidence: 99%

See 1 more Smart Citation

Laryngeal Trauma: Common Findings and Imaging Pearls

Lorenzo¹,

Peterson²,

Hudgins³

2013

neurograph

View full text Add to dashboard Cite

“…Helical CT provides anatomical details on laryngeal integrity and is useful when immobilization of the cervical spine is necessary. Studies describing the characteristics of the helical CT test to detect PCT laryngotracheal lesions are limited, but sensitivity and specificity are considered high (Robinson et al, 2009).Other possibilities with nasopharyngoscopy, which is flexible and laryngoscopy provide additional methods for assessing laryngotracheal trauma. Endoscopy allows a complete assessment when the dispersion artifact of metallic objects obscures helical CT images.…”

Section: Diagnostic Exams and Their Uses In Specific Injuriesmentioning

confidence: 99%

Medical Approach in Penetrant Cervical Trauma: An Educational View

Zambrana¹,

Kairala²,

Etrusco³

et al. 2020

JEHD

View full text Add to dashboard Cite

Doubts about procedures are common within the medical field, especially within the area of surgical clinic or medical surgery. In view of this explanation, the present was limited to carrying out a literary review on the subject of penetrating cervical trauma. To this end, research was carried out in databases linked to health and medicine, with specific descriptors for the subject, and articles from the years 2000 to 2020 were selected to clarify the subject. Penetrating cervical traumas are injuries to the neck that go beyond the platysma muscle. There is currently a great debate about the conduct to be adopted in such injuries. Penetrating cervical trauma comprises 5% to 10% of traumatic injuries in adults. In the last decade, mortality from penetrating cervical trauma was approximately 5%. The initial approach in the emergency room should be systematized in order to quickly identify possible signs of severity that usually require the immediate transfer of the patient to the operating room. Clinical examinations should be performed in order to elucidate and direct the surgeon to the best treatment for the patient. Finally, it is possible to conclude that cervical injuries are better treated with selective management.

show abstract

Multidetector Row Computed Tomography of the Injured Larynx After Trauma

Cited by 18 publications

References 22 publications

Airway management changes associated with rising radiologic incidence of external laryngotracheal injury

Airway management changes associated with rising radiologic incidence of external laryngotracheal injury

Laryngeal Trauma: Common Findings and Imaging Pearls

Medical Approach in Penetrant Cervical Trauma: An Educational View

Contact Info

Product

Resources

About