Injury to the larynx


 * We divide into internal and external ,
 * according to localization, it can also be divided into supraglottic, glottic, subglottic .

Foreign Bodies

 * Bodies wedged in the entrance to the larynx are manifested by an immediate attack of violent coughing, laryngospasm , dysphonia , pain,
 * bodies located in the subglottic region – dyspnea with expiratory stridor ,
 * chronic foreign body causes local inflammation with the formation of granulations,
 * in the case of organic foreign bodies, a general reaction of the organism may occur, there is a risk of swelling of the body and thus its extraction is impaired,
 * therapy – removal by direct or indirect laryngoscopy, sometimes it is necessary to perform a tracheostomy to secure the airways.

Iatrogenic Internal Injuries



 * During or after intubation, by the action of the intubation tube,
 * there are mucosal injuries of the entrance, glottis and subglottis with blood suffusion, edema,
 * sometimes lacerations with bleeding,
 * more rarely, there may be an abruption of the vocal cords or dislocation of the arytenoid cartilage,
 * erosions often become secondarily infected (typically formation of post-intubation granulomas),
 * it can lead to stenoses,
 * it is often due to inadequate size of the endotracheal tube,
 * the cuff must not be inflated in the glottis and subglottis area (high risk of stenoses),
 * safe intubation time – adults approx. 48 hours, children 5–6 days,
 * finding – shortness of breath, less often voice disorder, appears 2–6 weeks after intubation,
 * therapy – endoscopic or surgical.

Toxic Effects

 * Corrosion along with corroding of the swallowing tract – the entrance to the larynx is affected,
 * the entire larynx is affected when inhaling toxic gases or hot fumes,
 * symptoms – inspiratory shortness of breath to suffocation, irritating cough,
 * odynophagia and dysphagia in case of injury to the entrance,
 * in the larynx – edema, fibrin coatings and mucosal necrosis,
 * therapy – early respiratory support – corticoids.

Blunt trauma

 * The complex is well protected by the surroundings (lower jaw, sternum...), moreover, it has clearance and when force is applied, it deflects in the direction of the force,
 * the most common cause of blunt injuries are traffic accidents, sports injuries, assaults, rarely hanging,
 * depending on the degree, we distinguish between coma and contusion .

Numbness of the larynx

 * The larynx has no signs of anatomical damage,
 * reflex cardiopulmonary arrest may occur.

Contusion of the larynx

 * The larynx is anatomically damaged,
 * suffusions, hematomas, distortion of the cricoarytenoid articulation, fractures of the thyroid cartilage,
 * most serious:
 * supraglottic avulsion – complete circumferential rupture of the larynx at the level of the ventricles, the upper part being pulled behind the mandible and the lower part behind the sternum,
 * subglottic dislocated fracture of the annular cartilage - the only circular support of the larynx collapses, obstruction,
 * laryngotracheal avulsion – separation of the larynx from the trachea, caused by a blow under the annular cartilage during hyperextension of the neck,
 * symptoms - palpation pain, neck swelling, hoarseness to aphonia, odynophonia, odynophagia, cough, hemoptysis, crepitation of fragments, inspiratory dyspnea,
 * therapy
 * in case of suffocation – securing the airways using a tracheostomy,
 * conservative procedure for minor injuries, for fractures without dislocation; voice calm, or feeding tube,
 * worse - surgical revision.

Open wounds

 * Cuts, incisions and stab wounds are rare,
 * open wounds are most often caused by fragments of glass or suicide attempts,
 * basic symptom – covering the wound with foamy blood, hemoptysis, irritating cough, shortness of breath,
 * therapy - in case of suffocation - fast and high-quality PP, intubation, tracheostomy, koniopuncture...,
 * tracheostomy is performed as far as possible from the site of injury,
 * surgical revision is almost always necessary.

Externí odkazy
Traumatické změny

Source

 * BENEŠ, Jiří. Study materials  [online]. ©2007. [feeling. 2009]. < http://jirben2.chytrak.cz/materialy/orl_jb.doc&#x20;&#x3E;.