Vol.101 No.4 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 101 No. 4 April 2008
Combined Laryngotracheal Separation and Hypopharyngoesophageal
Injury Following Blunt Neck Trauma
Takeo Nonoda, Keiichi Izuhara, Toshimitsu Ohhashi and Masami Ohnishi
(Oogaki Municipal Hospital)
A 16-year-old boy underwent total laryngectomy following neck injury. While riding a bike, he was chased by police officers. He sped into a gas station, where a metal chain was used to block the entrance. As he did not notice the chain, his neck was strongly pulled back by the chain when he entered the gas station. He demonstrated dyspnea, stridor and dysphonia as a result of the injury. Surgical findings showed that his larynx was attached only to the hypopharynx at the upper portion although the skin was intact. The larynx was completely separated from the trachea between the cricoid cartilage and the first ring of the trachea and was ripped from the esophagus. A full-thickness laceration of the anterior esophagus extending obliquely into both pyriform sinuses was identified. We also found a purulent discharge in saliva leaking from the lacerated mucosa. As the wound was thought to be infected and difficult to sutured between the larynx and esophagus without saliva leakage, total laryngectomy was performed in order to avoid severe deep infection causing mediatinal abscess.
Key words :laryngotracheal separation, hypopharyngoesophageal injury, total laryngectomy