Khalid Noor, Bilal Muhammad, Umer Muhammad
Department of Otorhinolaryngology, Rawalpindi Medical University, Rawalpindi, Pakistan.
Department of Otorhinolaryngology, Foundation University Medical College, Islamabad, Pakistan.
Turk Arch Otorhinolaryngol. 2021 Mar;59(1):65-75. doi: 10.4274/tao.2020.6093. Epub 2021 Mar 26.
Non-traumatic laryngeal fractures are an extremely uncommon presentation, and the diagnosis can be missed. Recognizing these fractures is important to appropriately direct management because most have a good prognosis and result in complete recovery. This article aimed to review the characteristics of all documented cases of non-traumatic fractures of the larynx. We sought to address questions related to the etiology, clinical presentation, and diagnostic assessment of this condition and provide recommendations about the management of these fractures. Electronic databases, mainly PubMed and Google Scholar, were searched for relevant literature with no language or time restrictions. Since 1950, 15 cases of non-traumatic laryngeal fractures have been documented in the medical literature. Out of these, thyroid cartilage fractures have been described in 14 patients, while only one instance demonstrated a fracture in the cricoid cartilage. Patients were managed conservatively using voice rest and observation with complete recovery in all cases. All patients who present with odynophagia, hoarseness, and tenderness over the thyroid cartilage after an episode of severe coughing or sneezing, should be evaluated for a thyroid cartilage fracture using laryngoscopy and computed tomography scan. Management of the airway should be the primary priority in any laryngeal injury, and further management performed after the airway is stable.
非创伤性喉骨折是一种极为罕见的病症,诊断时可能会被漏诊。认识到这些骨折对于合理指导治疗很重要,因为大多数患者预后良好,可完全康复。本文旨在回顾所有已记录的非创伤性喉骨折病例的特征。我们试图解决与该病症的病因、临床表现和诊断评估相关的问题,并提供有关这些骨折治疗的建议。通过检索主要的电子数据库,即PubMed和谷歌学术搜索相关文献,不受语言或时间限制。自1950年以来,医学文献中已记录了15例非创伤性喉骨折病例。其中,14例患者出现甲状软骨骨折,而环状软骨骨折仅1例。所有患者均采用声休和观察的保守治疗方法,最终全部康复。对于所有在剧烈咳嗽或打喷嚏后出现吞咽痛、声音嘶哑和甲状软骨压痛的患者,均应使用喉镜和计算机断层扫描评估是否存在甲状软骨骨折。在任何喉部损伤中,气道管理都应是首要任务,在气道稳定后再进行进一步治疗。