Upper airway trauma

Abstract

Twelve cases of injury to the upper airway due to external trauma seen over a seven year period in the emergency department are presented. Four injuries resulted from penetrating trauma and eight from blunt trauma. Active airway management was initially required in seven patients. Two patients died of severe neurological injury despite appropriate airway management. Surgical intervention was undertaken in five of the ten survivors, with good results. One patient was discharged with a tracheostomy. All patients presented with symptoms or signs of airway injury. However, airway injuries are uncommon, patients may present without signs or symptoms and these injuries may be overlooked, with potentially disastrous consequences. Airway trauma should be suspected in all cases of blunt or penetrating trauma to the head, neck or chest. Emphasis should be placed on control of the airway and judicious performance of diagnostic procedures, followed by surgical repair where indicated.