Injury to the larynx

From WikiLectures

  • 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]

Laryngeal stenosis
  • 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,
  • 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[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]

Traumatické změny

Source[edit | edit source]

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 .