Injury to the larynx
- We divide into internal and external ,
- according to localization, it can also be divided into supraglottic, glottic, subglottic .
Internal Injuries[edit | edit source]
Foreign Bodies[edit | edit source]
- 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[edit | edit source]
- 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[edit | edit source]
- 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.
External Injuries[edit | edit source]
Blunt trauma[edit | edit source]
- 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[edit | edit source]
- The larynx has no signs of anatomical damage,
- reflex cardiopulmonary arrest may occur.
Contusion of the larynx[edit | edit source]
- 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,
- 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[edit | edit source]
- 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.
Odkazy[edit | edit source]
Externí odkazy[edit | edit source]
Source[edit | edit source]
- BENEŠ, Jiří. Study materials [online]. ©2007. [feeling. 2009]. < http://jirben2.chytrak.cz/materialy/orl_jb.doc+>.
References[edit | edit source]
- KLOZAR, Jan, et al. Speciální otorinolaryngologie. 1. vydání. Praha : Galén, 2005. 224 s ISBN 80-7262-346-X .
- HAHN, Aleš, et al. Otorinolaryngologie a foniatrie v současné praxi. 1. vydání. Praha : Grada, 2007. 390 s. ISBN 978-80-247-0529-3 .