The patient was a 13-year-old boy. He hit his anterior neck and upper lip against a pillar when he played tag with a friend at school on May 12th 1998. Immediately, his voice became hoarse. He complained of neither dyspnea nor dysphasia. He visited our hospital on May 15th. Fiberscopic flexible laryngoscopy was performed. Submucosal hemorrhage in the hypopharynx, left false cord, left vocal cord, and trachea was observed. Furthermore, movability of the left vocal cord was limited. He underwent a CT scan of the larynx. No cartilaginous fracture existed and he was treated conservatively. Ten days later, his hoarse voice improved. Six weeks later, the vocal cords moved well, though slight submucosal hemorrhage remained. Eleven weeks later, he recovered from his laryngeal trauma completely. Immediate airway management is the greatest concern in the care of blunt laryngeal trauma. In this case, the airway, remained safe.
The patient was an eight-month-old girl. At first, cough and hoarseness appeared. Inspiratory stridor began within two days and the next day, a barky cough was noticed. Laryngeal fiberscopy showed that the subglottic epithelium was reddish and swellen. She was treated with antibiotics: intravenous steroid and epinephrine-steroid inhalation and an O2 nebulizer (humidifier). Next day, these symptoms improved. Although hoarseness remained, subglottic epithelium swelling and redness were reduced. On the sixth day (hospitalization), the patient was discharged. We investigated 20 cases in our facilities from Jan.1994 to Jul.1998. There were sixteen cases less than four years an age and there were more boys than girls. (boys.13 cases). There were seven cases in summer, five cases in winter and four cases in spring and autumn. Clinical symptoms improved after several days in all cases. We did not need intubation or tracheostomy.
We reported three cases with dyspnea, stridor and cyanosis. The first case had a cleft epigottis with prolapse of the two halves of the epiglottis into the laryngeal inlet on inspiration. The second case had a white mass attached to the upper portion of the right tonsil. The third case was an 11-day neonate with a large cyst on the right side of the tongue base. Surgical therapy was performed on each patient, with the result that each symptom of respiratory disorder disappeared.
Retropharyngeal abscesses are rare, but they are sometimes fatal, particularly in infants. Two cases of retropharyngeal abscess were treated at our hospital during the past ten years. One was a 13-month-old boy who had been hospitalized in the pediatrics department for a month with complaints of fever, stridor and dysphagia. Another was a one-month-old boy who had been hospitalized at the pediatrics department for two weeks with complaints of fever and stridor. After transfer to our department, they were diagnosed as having retropharyngeal abscess. Widening of the prevertebral space was noted in the lateral neck film. Both patients received incision and drainage under general anesthesia and antibiotics were administered intravenously. In both patients, Staphylococcus aureus was isolated from purulent discharge.