Kuttenberger J J Johannes J, Hardt Nicolas, Schlegel Christoph
Department of Oral and Maxillofacial Surgery, Kantonsspital Luzern, Switzerland.
J Craniomaxillofac Surg. 2004 Apr;32(2):80-4. doi: 10.1016/j.jcms.2003.11.002.
Laryngotracheal injuries are uncommon with an estimated incidence of 1 per thousand (1-6 patients per 15000-42500 trauma victims). They may be associated with fractures of the facial skeleton. Their symptoms are variable ranging from obvious airway obstruction to minor or almost missing symptoms. Early diagnosis and proper initial management may sometimes be difficult or delayed.
Three patients with maxillofacial fractures and concomitant laryngotracheal injuries are presented. The diagnostic procedures used and the management of these injuries are reported.
Due to their low incidence and their hidden nature laryngotracheal injuries may pose diagnostic problems, especially in polytraumatized or intubated patients. Subcutaneous emphysema is the chief clinical sign. Fibreoptic endoscopy is the most important and informative diagnostic examination. Radiographic evaluation by CT scan provides additional information about the extent of the injury and the indication for surgery. A coordinated team approach is necessary for proper management of these injuries.
喉气管损伤并不常见，估计发病率为千分之一（每15000 - 42500名创伤患者中有1 - 6例）。它们可能与面骨骨折相关。其症状多样，从明显的气道阻塞到轻微或几乎没有症状。早期诊断和适当的初始处理有时可能困难或延迟。
本文介绍了3例伴有喉气管损伤的颌面骨折患者。报告了所采用的诊断程序及这些损伤的处理方法。
由于喉气管损伤发病率低且具有隐匿性，可能会带来诊断问题，尤其是在多发伤或插管患者中。皮下气肿是主要的临床体征。纤维内镜检查是最重要且能提供信息的诊断检查。CT扫描的影像学评估可提供有关损伤程度及手术指征的额外信息。对于这些损伤的妥善处理，需要多学科团队协作。
