Pereira Cláudia, Lopes Freitas Rafaela, Pereira Cristina, Oliveira Nuno, Carvalho Daniela
Anesthesiology, Hospital Pedro Hispano, Matosinhos, PRT.
Internal Medicine, Hospital Pedro Hispano, Matosinhos, PRT.
Cureus. 2024 Nov 30;16(11):e74811. doi: 10.7759/cureus.74811. eCollection 2024 Nov.
Isolated cricoid fractures are exceedingly rare but can be life-threatening. Injuries caused by minor neck trauma related to external laryngeal manipulation or an inappropriate tube cuff size have been reported in the literature. Symptoms typically appear immediately after the traumatic episode. Voice changes, respiratory distress, or deglutition problems may be present, although some patients may initially be asymptomatic. Here, we report a case of a 28-year-old woman with a history of recurrent dysphonia and respiratory distress after an episode of voluntary drug intoxication requiring orotracheal intubation and mechanical ventilation. The initial diagnostic workup was apparently normal, but conservative treatment did not resolve the symptoms. The progressive stridor episodes ultimately led to the correct diagnosis of a posterior cricoid fracture and abscess. The airway was secure with a transient tracheostomy, and the fracture was managed conservatively with no sequelae. A high level of suspicion is essential for the timely identification of these injuries to minimize the associated morbimortality, particularly in situations without obvious neck trauma and insidious symptoms.
孤立性环状软骨骨折极为罕见,但可能危及生命。文献中曾报道过因外部喉部操作或气管插管套囊尺寸不当导致的轻微颈部创伤所引起的损伤。症状通常在创伤事件后立即出现。可能会出现声音改变、呼吸窘迫或吞咽问题,不过有些患者最初可能并无症状。在此,我们报告一例28岁女性病例,该患者在一次自愿药物中毒发作后出现反复发声困难和呼吸窘迫,此次发作需要进行口气管插管和机械通气。最初的诊断检查结果显然正常,但保守治疗未能缓解症状。进行性喘鸣发作最终导致正确诊断为环状软骨后部骨折并伴有脓肿。通过临时气管切开术确保了气道安全,骨折采用保守治疗,未留下后遗症。对于及时识别这些损伤以将相关的发病率和死亡率降至最低而言,高度怀疑至关重要,尤其是在没有明显颈部创伤和隐匿性症状的情况下。