Butler Allen P, Wood Brennan P, O'Rourke Ashli K, Porubsky Edward S
Department of Otolaryngology-Head and Neck Surgery, Medical College of Georgia, Augusta, Georgia 30912, USA.
Ann Otol Rhinol Laryngol. 2005 May;114(5):361-8. doi: 10.1177/000348940511400505.
The purpose of this report is to promote early recognition, expeditious evaluation, and judicious management of acute external laryngeal trauma. A retrospective chart review was performed of 112 cases that were managed at a Medical College of Georgia tertiary care hospital by the senior author (E.S.P.). Patients were classified by the time of their presentation, the severity of their injury, and the treatment protocol followed. The clinical outcomes of airway, voice quality, and deglutition were retrospectively reviewed. For voice outcomes, in the delayed treatment group, only 27.7% of patients had a good result, as compared to a 78.3% good result in the early treatment group. Similar differences were demonstrated regarding the airway. In the delayed treatment group, only 73.3% had good airway function, as compared to 93.3% who had good airway function in the early treatment group. Ninety-nine percent of all patients had a good result for deglutition. We conclude that expeditious diagnosis and intervention reduce the incidence of suboptimal clinical outcomes, and with timely and appropriate application of diagnostic and management protocols, the majority of patients will be successfully decannulated (97%) with functional speech (100%) and normal deglutition (99%).
本报告的目的是促进对急性喉外部创伤的早期识别、快速评估和合理处理。资深作者(E.S.P.)对佐治亚医学院三级护理医院收治的112例病例进行了回顾性病历审查。根据患者就诊时间、损伤严重程度以及所遵循的治疗方案进行分类。对气道、嗓音质量和吞咽功能的临床结局进行了回顾性分析。就嗓音结局而言,延迟治疗组仅有27.7%的患者效果良好,而早期治疗组这一比例为78.3%。气道方面也显示出类似差异。延迟治疗组仅有73.3%的患者气道功能良好,而早期治疗组这一比例为93.3%。所有患者中99%的吞咽功能良好。我们得出结论,快速诊断和干预可降低不良临床结局的发生率,通过及时、适当地应用诊断和处理方案,大多数患者将成功拔管(97%),拥有功能性嗓音(100%)和正常吞咽功能(99%)。