Resident Manual of Trauma to the Face, Head and Neck

Mild laryngeal trauma may be managed with patient observation and adjunctive measures, such as humidified air, voice rest, steroids, and head-of-bed elevation. If the airway becomes precarious or the patient is at risk of airway compromise, an awake tracheotomy should be performed in the operating room. In general, displaced laryngeal cartilage fractures should be repaired with miniplates to establish a stable laryngeal framework. Mucosal lacerations should be primary repaired with 5-0 or 6-0 absorbable sutures. Stents may be placed if the anterior commissure is significantly injured or if there are multiple, severe endolaryngeal lacerations. These stents are usually removed at 2 weeks post-placement via an endo- scopic procedure in the operating room. Finally, speech therapy plays a vital role in the recovery and rehabilitation of patients who suffer laryngeal trauma. VIII. References Jalisi S, Zoccoli M. Management of laryngeal fractures—A 10-year experience. Journal of Voice. Jul 2011;25(4):473-479. Jewett BS, Shockley WW, Rutledge R. External laryngeal trauma analysis of 392 patients. Archives of Otolaryngology–Head & Neck Surgery. Aug 1999;125(8):877-880. Kantas I, Balatsouras DG, Kamargianis N, Katotomichelakis M, Riga M, Danielidis V. The influence of laryngopharyngeal reflux in the healing of laryngeal trauma. European Archives of Oto-Rhino-Laryngology. Feb 2009;266(2):253-259. Mendelsohn AH, Sidell DR, Berke GS, John MS. Optimal timing of surgical intervention following adult laryngeal trauma. Laryngoscope. Oct 2011;121(10):2122-2127. Norris BK, Schweinfurth JM. Arytenoid dislocation: An analysis of the contemporary literature. Laryngoscope. Jan 2011;121(1):142-146. Quesnel AM, Hartnick CJ. A contemporary review of voice and airway after laryngeal trauma in children. Laryngoscope. Nov 2009;119(11): 2226-2230. Schaefer SD. The acute management of external laryngeal trauma. A 27-year experience. Archives of Otolaryngology–Head & Neck Surgery. 1192;118(2):598-604.

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