A Case Series: Overcoming Challenges of Delayed Intervention in Comminuted Laryngeal Fractures Using Adaptation Miniplates
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Abstract
Introduction: Laryngeal trauma presents significant challenges in emergency medicine, often resulting from motor vehicle accidents. This study delves into the management of comminuted laryngeal fractures resulting from such accidents, utilizing the Schaefer-Fuhrman classification and the Legacy Emanuel Hospital and Health Center (LEHHC) Laryngeal Injury Classification for diagnosis and treatment guidance. Case series: Through the examination of three cases of comminuted laryngeal fracture, we have showcased the feasibility and efficacy of open reduction and fixation utilizing adaptive miniplates. The first and second cases involved comminuted fracture of thyroid cartilage which had delayed tracheostomy and fixation and adaptation of miniplates at day 16. The third case presented with comminuted and depressed thyroid and hyoid fracture which had delayed tracheostomy and fixation and adaptation of miniplates at day 6. All cases were decannulated eventually. Conclusion: Recommended for both stable and unstable thyroid fractures, these methods enable stabilization and bridging of any small cartilage losses incurred during the injury and subsequent repair process. Despite challenges such as delayed fracture stabilization due to the necessity of airway expertise, the positive outcomes observed in our cases underscore the potential for successful management even in complex scenarios.
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Malvi A, Jain S. Laryngeal Trauma, Its Types, and Management. Cureus n.d.;14:e29877. https://doi.org/10.7759/cureus.29877.
Schaefer SD. Primary Management of Laryngeal Trauma. Ann Otol Rhinol Laryngol 1982;91:399–402. https://doi.org/10.1177/000348948209100416.
Fuhrman GM, Stieg FH, Buerk CA. Blunt laryngeal trauma: classification and management protocol. J Trauma 1990;30:87–92.
Verschueren DS, Bell RB, Bagheri SC, Dierks EJ, Potter BE. Management of laryngo-tracheal injuries associated with craniomaxillofacial trauma. J Oral Maxillofac Surg Off J Am Assoc Oral Maxillofac Surg 2006;64:203–14. https://doi.org/10.1016/j.joms.2005.10.034.
Pou AM, Shoemaker DL, Carrau RL, Snyderman CH, Eibling DE. Repair of laryngeal fractures using adaptation plates. Head Neck 1998;20:707–13.https://doi.org/10.1002/(sici)1097-0347(199812)20:8<707::aid-hed8>3.0.co;2-y.
Türkmen S, Cansu A, Türedi S, Eryigit U, Sahin A, Gündüz A, et al. Age-dependent structural and radiological changes in the larynx. Clin Radiol 2012;67:e22-26. https://doi.org/10.1016/j.crad.2012.07.006.
Becker M, Leuchter I, Platon A, Becker CD, Dulguerov P, Varoquaux A. Imaging of laryngeal trauma. Eur J Radiol 2014;83:142–54. https://doi.org/10.1016/j.ejrad.2013.10.021.
Eller, Robert L., Dion, Gregory, Spadaro, Erin. “Management of acute laryngotracheal trauma.” Otolaryngology/head and neck surgery combat casualty care in operation Iraqi freedom and operation enduring freedom: Ed. Banks, D. E: 376-398. n.d. https://scholar.googleusercontent.com/scholar?q=cache:EtqBDPoneBoJ: scholar.google.com/+dexam ethasone++laryn geal+trauma &hl=en&as_sdt= 0,5& as_ylo=2014 (accessed November 20, 2024).
Sandhu G, Nouraei SAR. Laryngeal trauma. Pract. Laryngol., CRC Press; 2015.
Bell RB, Verschueren DS, Dierks EJ. Management of laryngeal trauma. Oral Maxillofac Surg Clin N Am 2008;20:415–30. https://doi.org/10.1016/j.coms.2008.03.004.
Schaefer SD. Management of acute blunt and penetrating external laryngeal trauma. The Laryngoscope 2014;124:233–44. https://doi.org/10.1002/lary.24068.
Kanno T, Sukegawa S, Furuki Y, Nariai Y, Sekine J. Overview of innovative advances in bioresorbable plate systems for oral and maxillofacial surgery. Jpn Dent Sci Rev 2018;54:127–38. https://doi.org/10.1016/j.jdsr.2018.03.003.