Outcome analysis of Post-traumatic Laryngotracheal Injury Repair (Retrospective Case Series)

Outcome analysis of Post-traumatic Laryngotracheal Injury Repair

Abstract

Introduction:Laryngotracheal injury is one of the rare of presentation of head and neck trauma. Traumatic injuries to larynx can be grouped as blunt trauma neck or penetrating injury neck. In previous reports , majority of injuries to larynx secondary to accidents were due to blunt trauma neck.Due to change in urban lifestyle and use of seat belts , the incidence of blunt trauma neck has reduced and that of penetrating injury neck is on the rise .Mortality rates from laryngotracheal injury range from 2-18%.In this single institutional case series , the patients presenting to our hospital with laryngotracheal injury had been studied. Aim : The aim of this case series is to study the various outcomes after laryngotracheal injury repair Methodology : All patients with laryngotracheal injury presenting to Emergency services between September 2015 and October 2017 have been recruited into the study and the outcomes are studied. A total of 20 patients have been studied. The outcome variables studied are rates of decannulation , voice restoration , duration of hospital stay , use of stenting , need for single or staged surgery. Results: 19 out of 20 patients underwent single stage surgery except 1 patient who had to undergo staged procedure. Average number of hospital stay was 12 days, Minimum duration being 4 days for Grade I, Maximum duration being 41 days for Grade IV. Grade IV injury patients after discharge had multiple out patient visits upto a period of 1-2 months . All patients had Ryles tube removed on Postoperative day five. 16 patients were successfully decannulated and 3 are still tracheostomised and under follow up. Successful decannulation rate of 80 % was observed in our series. Voice restoration achieved in all 16 patients who were decannulated. 80 % success rate was achieved in voice restoration. Conclusion: Though laryngotracheal injury is uncommon and a life threatening injury , if management is planned according to the Schaefer-Fuhrman grading system successful decannulation and voice restoration rates are possible. Systematic approach and timely management is required for a favourable outcome. [Manu B SEAJCRR 2017; 7(43):9-13]