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Laryngotracheal disruption from blunt pediatric neck injuries: impact of early recognition and intervention on outcome.

Abstract：

:Blunt and penetrating neck injuries are an infrequent cause of morbidity and mortality in the pediatric population. Although less common than penetrating injuries, blunt pediatric neck injuries are more often life-threatening because of associated laryngotracheal disruption. The authors reviewed their experience with pediatric neck injuries over the past 5 years. There were nine blunt and 14 penetrating injuries, representing 0.5% of the trauma admissions. There was no significant difference in age or gender distribution between the two groups. Blunt pediatric neck injuries were more often associated with frank respiratory distress at the time of presentation. Massive subcutaneous emphysema and hoarseness were the most common symptoms encountered. All patients with blunt injury underwent direct laryngoscopy and bronchoscopy (DL & B) and esophagoscopy. DL & B results were positive for eight patients; seven patients underwent neck exploration and successful repair of the laryngotracheal injuries. There were two deaths; one of these patients had laryngeal transection, which was not recognized at the time of DL & B. The other death resulted from associated tracheobronchial disruption secondary to massive blunt chest trauma. The patients with penetrating neck injuries were more likely to be treated nonoperatively, to have a shorter stay in the hospital and intensive care unit, and to have a lower injury severity score. There were no deaths in this group. The authors conclude that all patients with blunt neck trauma should undergo emergent and meticulous DL & B. Visualization of laryngotracheal disruption mandates immediate neck exploration and primary repair.

journal_name

J Pediatr Surg

journal_title

Journal of pediatric surgery

authors

Ford HR,Gardner MJ,Lynch JM

doi

10.1016/0022-3468(95)90584-7

subject

Has Abstract

pub_date

1995-02-01 00:00:00

pages

331-4; discussion 334-5

issue

2

eissn

0022-3468

issn

1531-5037

pii

0022-3468(95)90584-7

journal_volume

30

pub_type

杂志文章

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