Throat trauma
Introduction
Brief introduction to laryngeal trauma There are two types of laryngeal trauma: closed injury and open injury. Acute laryngeal trauma is easy to cause airway obstruction, which can be life-threatening. If improperly handled, it will cause chronic laryngeal stenosis, dysphonia or difficulty in extubation. Therefore, acute laryngeal trauma should be diagnosed and treated early by specialists to avoid or reduce the complications of laryngeal trauma. Laryngeal contusion is easy to cause submucosal edema, hematoma, mucosal tear, cartilage fracture and dislocation, etc. Common symptoms are: respiratory tract obstruction causing dyspnea and throat wheezing; pronunciation change or aphasia; cough, hemoptysis, neck pain and swallowing Pain, dislocation of laryngeal cartilage has two kinds of dislocation of the ring joint and dislocation of the ankle joint. The anterior thyroid cartilage is often located behind the armor joint surface. The neck pain of the affected side can be radiated to the ear. The recurrent laryngeal nerve through the ring arm joint is often affected. Injury leads to a loss of sound. In some patients, although there is no recurrent laryngeal nerve injury, sound changes can occur; the latter have hoarseness, local pain, difficulty swallowing, and even difficulty breathing. basic knowledge The proportion of sickness: 0.29% Susceptible people: no specific population Mode of infection: non-infectious Complications: shock edema mediastinal emphysema
Cause
Cause of laryngeal trauma
Closed injuries include laryngeal contusion, cartilage fracture and dislocation. The reason is that traffic accidents are the first. The general car accidents are multiple injuries. Laryngeal trauma is one of them. The steering wheel of the car, the back of the instrument panel and the seat are easy to directly hit the throat. This type of trauma is called dashboard syndrome; followed by athletic competition (boxing, ball strikes, etc.); then accidental accidents; other iatrogenic injuries such as endoscopy or endotracheal intubation.
Open injuries include laryngeal stab wounds, cuts and penetrating wounds. The main reasons are gunshot wounds and sharp injuries. The former is more in wartime, and the latter is usually the latter.
Prevention
Laryngeal wound prevention
The main purpose is to prevent trauma to the throat, and should be sent to the hospital for emergency treatment in case of trauma.
Complication
Laryngeal trauma complications Complications, shock, edema, mediastinal emphysema
Symptoms and signs of laryngeal trauma vary depending on the type of weapon being wounded, the speed of the bullet, and the location of the injury. The early prominent symptom is bleeding. Although it does not necessarily damage the main aorta of the neck, it may also be caused by blood flowing into the airway. Sudden death, or shock due to excessive blood loss, followed by tissue edema, hematoma and aneurysm caused by breathing difficulties, subcutaneous emphysema, mediastinal emphysema, dysphagia and dysphonia may also occur.
After laryngeal cartilage fracture, it is easy to have subcutaneous emphysema in the neck; airway obstruction; palpation has a fracture sign such as thyroid cartilage larynx or ring cartilage arched process disappears; there is mucosal tear in the laryngeal cavity.
Symptom
Throat trauma symptoms Common symptoms Pronunciation change dysphonia Dysphagia Dysphagia Dyspnea respiratory tract obstruction edema speech frequency is small, no... excessive blood loss paralysis
Laryngeal contusion is easy to cause submucosal edema, hematoma, mucosal tear, cartilage fracture and dislocation, etc. Common symptoms are: respiratory tract obstruction causing dyspnea and throat wheezing; pronunciation change or aphasia; cough, hemoptysis, neck pain and swallowing Pain, dislocation of laryngeal cartilage has two kinds of dislocation of the ring joint and dislocation of the ankle joint. The anterior thyroid cartilage is often located behind the armor joint surface. The neck pain of the affected side can be radiated to the ear. The recurrent laryngeal nerve through the ring arm joint is often affected. Injury causes a loss of sound. In some patients, although there is no recurrent laryngeal nerve injury, the sound can still change. The latter has hoarseness, local pain, difficulty in swallowing, and even difficulty breathing. The examination shows that the sacral area and the sputum can be swollen and swollen, and the vocal cords can be hidden. When the swelling subsides, the sacral cartilage can be displaced forward, and the vocal cords are elastic and curved, and the glottis cannot be closed when the sound is pronounced.
After laryngeal cartilage fracture, it is easy to have subcutaneous emphysema in the neck; airway obstruction; palpation has a fracture sign such as thyroid cartilage larynx or ring cartilage arched process disappears; there is mucosal tear in the laryngeal cavity.
Most of the laryngeal injuries are self. Usually, those who are clinically seen are mostly suicide attempts. Half of them are stab wounds. Most of the cuts with sharp blades are rampant, and the cuts are made. According to the comprehensive statistics of the report, the thyroid cartilage was the first (33.0%), followed by the thyroid periosteum (31.1%), the ring membrane (12.1%), the ring cartilage (9.8%), the trachea (8.0%), and the upper part of the hyoid (5.7). %), symptoms are nothing more than hoarseness, aphonia, difficulty breathing, cough, hemoptysis, etc., complications may have wound infection, perichondritis, difficulty in extubation, secondary bleeding, subcutaneous emphysema, mediastinal emphysema, vocal cords Paralysis, tracheoesophageal fistula, pneumonia and mediastinal inflammation.
Symptoms and signs of laryngeal penetrating injury, depending on the type of weapon, the speed of the bullet and the location of the injury, the early prominent symptom is bleeding, although not necessarily the main aorta of the neck, but also due to blood flow into the airway Sudden death, or shock due to excessive blood loss, followed by tissue edema, hematoma and aneurysm caused by breathing difficulties, subcutaneous emphysema, mediastinal emphysema, dysphagia and dysphonia may also occur.
Examine
Laryngeal trauma examination
Examination can be seen that the sacral area and sputum can be swollen and swollen, and the vocal cords can be hidden. When the swelling subsides, the sacral cartilage can be displaced forward, the vocal cords are loose and curved, and the glottis cannot be closed when the sound is pronounced.
Diagnosis
Diagnosis of laryngeal trauma
The disease can be diagnosed according to clinical and examination, without identification.
