Laryngeal injury


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

Foreign bodies

 * Bodies wedged at the entrance to the larynx are manifested by an immediate attack of a severe cough, laryngospasm, dysphonia, pain,
 * bodies located in the subglottic area - dyspnea with expiratory stridor,
 * chronic foreign body causes local inflammation with the formation of granulations,
 * in the case of organic foreign bodies, the overall 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 action of the intubation tube,
 * mucosal injuries of the entrance, glottis and subglottis with blood suffixes, edema,
 * sometimes market injuries with bleeding,
 * rarely, vocal cord abruption to infection (typically postintubation granuloma formation),
 * erosions are often secondary to infection (typically postintubation granuloma formation),
 * it can lead to stenosis,
 * this is often due to the inadequate size of the endotracheal cannula,
 * the cuff most 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 disorders, occurs 2-6 weeks after intubation,
 * therapy - endoscopic or surgical.

Toxic effects

 * Corrosion together with corrosion of swallowing pathways - the entrance to the larynx is affected,
 * the whole larynx is affected by inhalation of toxic gases or hot fire gases,
 * symptoms - inspiratory dyspnoea to suffocation, irritating cough,
 * in case of entrance injury also odynophagia and dysphagia,
 * in the larynx - edema, fibrin coatings to necrosis of the mucosa,
 * therapy - early respiration - corticoids.

Blunt injuries

 * The complex is well protected by the environment (lower jaws, sternum...), in addition it has clearance and, when a force i applied, it dodges in the direction of the applied force,
 * the most common causes of blunt injuries are traffic accidents, sports accidents, assaults, rarely hanging,
 * according to the degree we distinguish between comedy and contusion.

Concussion larynx

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

Contusion of the larynx

 * larynx is anatomically damaged,
 * suffusings, hematomas, cricoarytenoid distortions, thyroid cartilage fractures,
 * most serious:
 * supraglottic avulsion - complete circumferential rupture of the larynx at the level of the ventricles, the upper part is displaced behind the mandible and the lower part behind sternum,
 * subglottic dislocated fracture of the annular cartilage - the only circular laryngeal support collapses, obstruction,
 * laryngotracheal avulsion - detachment of the larynx from the trachea, caused by blow under the annular cartilage during hyperextension of the neck,
 * symptoms - palpable pain, swelling of the throat, hoarseness to aphonia, odynophonia, odynophagia, cough, hemoptysis, crepitation of fragments, inspiratory dyspnoea,
 * therapy
 * for suffocation - securing the airways by tracheostomy
 * conservative procedure for minor injuries, for fractures without dislocations, voice calm, or food probe,
 * worse– surgical revision.

Open injuries

 * Cuttings, cuts and stab wounds are rare,
 * most often open injuries are caused by glass fragments or suicide attempts,
 * basic symptom - infused wound with foamy blood, hemoptysis, irritating cough, dyspnoea,
 * therapy - in case of suffocation - fast and high-quality PP, intubation, tracheostomy, coniopuncture,...,
 * we do tracheostomy as far as possible from the place of injury,
 * surgical revision is almost always required.