Menke Bryant A, Spencer John D, Dowdall Jayme R
University of Nebraska Medical Center, Department of Otolaryngology-Head and Neck Surgery, 981225 Nebraska Medical Center, Omaha, NE 68198-1225, United States of America.
Trauma Case Rep. 2022 Dec 31;43:100752. doi: 10.1016/j.tcr.2022.100752. eCollection 2023 Feb.
Penetrating trauma to the larynx is a rare phenomenon with a high risk of mortality and morbidity due to the density of vital structures in the area (Demetriades et al., 1996). Most commonly, this type of injury is due to a gunshot wound or knife injury (Snow and Ballenger, 2003). In cases of suicidal cutthroat injury, it is relatively rare to penetrate the airway (Symbas et al., 1976).
We present a case of self-penetrating trauma to the anterior neck allowing access for direct laryngeal visualization and transcervical intubation in the field. We describe the immediate workup, surgical intervention, and postoperative management. We focus on managing postoperative cough, secretion management, decannulation, and resultant dysphagia.
Penetrating laryngeal trauma resulting in airway transection is a rare but potentially fatal phenomenon in which airway management and aggressive post-operative care for severe coughing and dysphagia should be performed to help improve patient outcomes.
由于该区域重要结构密集，喉部穿透伤是一种罕见现象，具有较高的死亡率和发病率（德米特里亚德斯等人，1996年）。最常见的是，此类损伤由枪伤或刀伤所致（斯诺和巴伦杰，2003年）。在自杀性割喉损伤病例中，穿透气道相对少见（辛巴斯等人，1976年）。
我们报告一例前颈部自穿透伤病例，在现场即可直接观察喉部并经颈部进行插管。我们描述了即时检查、手术干预及术后管理。我们重点关注术后咳嗽的处理、分泌物管理、拔管以及由此导致的吞咽困难。
导致气道横断的穿透性喉外伤是一种罕见但可能致命的现象，应进行气道管理以及针对严重咳嗽和吞咽困难的积极术后护理，以帮助改善患者预后。
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