Larynx Fracture

Larynx Fracture is a topic covered in the 5-Minute Emergency Consult.

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Basics

Description

  • Direct transfer of severe forces to the larynx
  • Simple mucosal tears to fractured and comminuted cartilage:
    • Epiglottis, thyroid, arytenoid, cricoid, corniculate, and cuneiform cartilages

Etiology

  • Rare: 1/5,000–1/42,000 ED visits
  • <1% of all blunt trauma
  • Directly related mortality is 2–15%
  • Blunt or penetrating trauma to the anterior neck associated with motor vehicle or motorcycle crash, assault, or recreational activities.
  • Typical mechanism is hyperextension of neck with a direct blow to the exposed anterior neck.
  • “Clothesline” injury is a classic mechanism (victim struck in neck by cord, wire, or branch hung across path of travel).
  • Iatrogenic injuries from intubation are becoming more common with an aging population.

Pediatric Considerations
Bicycle handlebars:
  • Extended neck hits the bar, compressing structures between the bar and vertebral column.

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Basics

Description

  • Direct transfer of severe forces to the larynx
  • Simple mucosal tears to fractured and comminuted cartilage:
    • Epiglottis, thyroid, arytenoid, cricoid, corniculate, and cuneiform cartilages

Etiology

  • Rare: 1/5,000–1/42,000 ED visits
  • <1% of all blunt trauma
  • Directly related mortality is 2–15%
  • Blunt or penetrating trauma to the anterior neck associated with motor vehicle or motorcycle crash, assault, or recreational activities.
  • Typical mechanism is hyperextension of neck with a direct blow to the exposed anterior neck.
  • “Clothesline” injury is a classic mechanism (victim struck in neck by cord, wire, or branch hung across path of travel).
  • Iatrogenic injuries from intubation are becoming more common with an aging population.

Pediatric Considerations
Bicycle handlebars:
  • Extended neck hits the bar, compressing structures between the bar and vertebral column.

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