Abstract
We treated a 39-year-old man with laryngeal injuries due to external blunt trauma. He suffered from slight difficulty in breathing, hoarseness, and swallowing pain localized to the area of the larynx. Examinations with a flexible endoscope and a CT scan revealed mild endolaryngeal edema, submucosal ecchymosis, and antero-lateral fracture of the cricoid cartilage displacing its anterior portion 5 mm inward without any overlying mucosal disruption. Since the cricoid fracture was not serious, we selected conservative therapy using the intravenous administration of Solu-Medrol®, consequently, the dyspnea was rapidly relieved. The swallowing pain and hoarseness have disappeared after several days. Submucosal ecchymosis in the subglottic area remained over 80 days, but no subglottic stenosis occurred. Presently, the vocal cords look normal, and their movement as well as the vibratory pattern observed by a stroboscope appear nomal. However, he has continued to demonstrate limitations in high-pitched phonation for 9 months. The detailed effects of laryngeal injuries in the case regarding the phonatory function remain unclear. Based on a literature review, we discuss the treatment of laryngeal trauma in order to elucidate the complex problems on both airway and phonatory function. In addition, we also emphasize the usefullness of 3D images reconstructed with helical CT to evaluate the skeletal integrity in cases of laryngeal trauma.
