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      Prehospital tracheotomy in a case of avulsion of the larynx with a comminuted fracture of the jawbone

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          Abstract

          Emergency physicians in the field are sometimes confronted with cases wherein patients cannot be intubated and ventilated. In some cases, cricothyrotomy, the method of choice for securing an emergency airway, may not have a successful outcome. We report a rare case of a 35-yearold male patient with avulsion of the larynx and a comminuted fracture of the jawbone, due to entrapment in a dung excavator. Prehospital tracheotomy was successfully performed. In cases with crush injuries to the larynx, anatomic structures, including the ligamentum conicum, are destroyed. In addition, massive subcutaneous emphysema blurs the anatomical key structures; hence, only a tracheotomy can prevent a lethal outcome.

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          Surgical Airway

          Sapna A Patel, Tanya Meyer (2014)
          Close to 3% of all intubation attempts are considered difficult airways, for which a plan for a surgical airway should be considered. Our article provides an overview of the different types of surgical airways. This article provides a comprehensive review of the main types of surgical airways, relevant anatomy, necessary equipment, indications and contraindications, preparation and positioning, technique, complications, and tips for management. It is important to remember that the placement of a surgical airway is a lifesaving procedure and should be considered in any setting when one “cannot intubate, cannot ventilate”.
          Article 0 comments Cited 7 times – based on 0 reviews     Review now
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            Clinical features and management of closed injury of the cervical trachea due to blunt trauma

            Dong Ye, Zhisen Shen, Yuyuan Zhang … (2013)
            Background We retrospectively reviewed the presentation, diagnosis, treatment, and outcomes of patients with closed injury of the cervical trachea. We evaluated factors that improve diagnosis and treatment, reduce mortality, and avoid tracheal stenosis. Methods We reviewed the clinical data of 17 patients with closed injury of the cervical trachea. All patients underwent CT scanning or endoscopy, tracheal exploration, low tracheotomy, and tracheal repair. Results In 12 patients, breathing, phonation, and swallowing functions had returned to normal at 2 weeks. In three patients, breathing and swallowing functions had recovered at 2 weeks, but hoarseness continued. In two patients, tracheal stenosis prevented extubation and required further surgery; in these patients breathing and swallowing functions had recovered at 6 months. Conclusions Closed injury of the cervical trachea may cause airway obstruction and is potentially life-threatening. Early diagnosis and repair to restore structure and function are important to ensure survival and avoid tracheal stenosis.
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              Isolated cricoid fracture associated with blunt neck trauma.

              Je Oh, Hyun Min, Tae Park … (2007)
              A 32-year-old woman without a remarkable history presented at the emergency department with strangulation of the neck. CT scans of the neck revealed a displaced cricoid fracture. Six days after admission to hospital, hoarseness and dyspnoea disappeared. On the 10th day, the patient was discharged without complications. The traditional treatment guidelines for laryngeal trauma have recommended an early surgical intervention after immediate tracheotomy in cases of displaced fractures of the cricoid cartilage. The patient could be treated successfully through continuous monitoring of airway obstruction without surgical management.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Clin Exp Emerg Med
                Journal ID (iso-abbrev): Clin Exp Emerg Med
                Journal ID (publisher-id): CEEM
                Title: Clinical and Experimental Emergency Medicine
                Publisher: The Korean Society of Emergency Medicine
                ISSN (Electronic): 2383-4625
                Publication date Collection: June 2019
                Publication date (Electronic): 3 April 2019
                Volume: 6
                Issue: 2
                Pages: 173-176
                Affiliations
                Surgical Department, Clinical Center Fuerth, Fuerth, Germany
                Author notes
                Correspondence to: Katharina Gaab Surgical Department, Clinical Center Fuerth, Jakob-Henle-Straße 1, 90766 Fuerth, Germany E-mail: katharina@ 123456gaab-web.de
                Author information
                http://orcid.org/0000-0001-7464-3509
                Article
                Publisher ID: ceem-18-016
                DOI: 10.15441/ceem.18.016
                PMC ID: 6614052
                PubMed ID: 30943686
                SO-VID: dfc91933-1fae-41c4-b0b5-2b1ecd78cff3
                Copyright © Copyright © 2019 The Korean Society of Emergency Medicine
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/).

                History
                Date received : 30 March 2018
                Date revision received : 5 April 2018
                Date accepted : 6 April 2018
                Categories
                Subject: Case Report

                Keywords: fractures, cartilage,emergency medical services,tracheotomy
                Data availability:
                Keywords: fractures, cartilage, emergency medical services, tracheotomy

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