Open Reduction and Fixation in Acute Laryngeal Trauma Under Endoscopic Guidance

EXTERNAL laryngeal trauma is a relatively uncommon injury estimated at approximately 1 in every 30,000 emergency room visits1. However, laryngeal injury can result in serious airway problems and impaired voice production if not diagnosed and managed properly, and the consequences of mistreatment are severe. Historically, the surgical repair of laryngeal fractures involved simple wire fixation of fragments with autologous cartilage grafts for large defects. Internal stents were used to preserve the proper three-dimensional shape of the airway when extraluminal repair could not ensure immediate restoration of a stable laryngeal framework. Although these techniques suffice to align fracture fragments, they do not always restore the functional architecture of the larynx2. With improved image resolution and quality of stroboscopy, videolaryngoscopy became a routine part of the examination of individuals with voice disorders3. However, its use was mainly for pre-operative assessment and post-operative follow-up. A MEDLINE search engine using MeSH Database with the keywords larynx, trauma, and fracture failed to find descriptions of endoscopic-guided management of laryngeal trauma. We describe the management of a case of laryngeal trauma under endoscopic guidance.