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Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 1/2013

Open Access 01-12-2013 | Original research

Clinical features and management of closed injury of the cervical trachea due to blunt trauma

Authors: Dong Ye, Zhisen Shen, Yuyuan Zhang, Shijie Qiu, Cheng Kang

Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine | Issue 1/2013

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Abstract

Background

We retrospectively reviewed the presentation, diagnosis, treatment, and outcomes of patients with closed injury of the cervical trachea. We evaluated factors that improve diagnosis and treatment, reduce mortality, and avoid tracheal stenosis.

Methods

We reviewed the clinical data of 17 patients with closed injury of the cervical trachea. All patients underwent CT scanning or endoscopy, tracheal exploration, low tracheotomy, and tracheal repair.

Results

In 12 patients, breathing, phonation, and swallowing functions had returned to normal at 2 weeks. In three patients, breathing and swallowing functions had recovered at 2 weeks, but hoarseness continued. In two patients, tracheal stenosis prevented extubation and required further surgery; in these patients breathing and swallowing functions had recovered at 6 months.

Conclusions

Closed injury of the cervical trachea may cause airway obstruction and is potentially life-threatening. Early diagnosis and repair to restore structure and function are important to ensure survival and avoid tracheal stenosis.
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Literature
1.
go back to reference Mussi A, Ambrogi MC, Ribechini A, Lucchi M, Menoni F, Angeletti CA: Acute major airway injuries: clinical features and management. Eur J Cardiothorac Surg. 2001, 20: 46-51. 10.1016/S1010-7940(01)00702-3. discussion 51–52CrossRefPubMed Mussi A, Ambrogi MC, Ribechini A, Lucchi M, Menoni F, Angeletti CA: Acute major airway injuries: clinical features and management. Eur J Cardiothorac Surg. 2001, 20: 46-51. 10.1016/S1010-7940(01)00702-3. discussion 51–52CrossRefPubMed
2.
go back to reference Valerio P, Ivan M, Francisco R, Ureña A, Ricard R, Ricardo M, Josep S, Ignacio E, Rosa V, Moya J: Survival after traumatic complete laryngotracheal transection. Am J Emerg Med. 2008, 26: 837-e3-4CrossRefPubMed Valerio P, Ivan M, Francisco R, Ureña A, Ricard R, Ricardo M, Josep S, Ignacio E, Rosa V, Moya J: Survival after traumatic complete laryngotracheal transection. Am J Emerg Med. 2008, 26: 837-e3-4CrossRefPubMed
3.
go back to reference Glinjongol C, Pakdirat B: Management of tracheobrochial injuries: a 10-year experience at Ratchaburi hospital. J Med Assoc Thai. 2005, 88: 32-40.PubMed Glinjongol C, Pakdirat B: Management of tracheobrochial injuries: a 10-year experience at Ratchaburi hospital. J Med Assoc Thai. 2005, 88: 32-40.PubMed
4.
go back to reference Poli-Merol ML, Belouadah M, Parvy F, Chauvet P, Egreteau L, Daoud S: Tracheobronchial injury by blunt trauma in children: is emergency tracheobronchoscopy always necessary?. Eur J Pediatr Surg. 2003, 13: 398-402.CrossRefPubMed Poli-Merol ML, Belouadah M, Parvy F, Chauvet P, Egreteau L, Daoud S: Tracheobronchial injury by blunt trauma in children: is emergency tracheobronchoscopy always necessary?. Eur J Pediatr Surg. 2003, 13: 398-402.CrossRefPubMed
5.
go back to reference Pinto JM, Ansley J, Baroody FM: Lack of utility of postoperative chest radiograph in pediatric tracheotomy. Otolaryngol Head Neck Surg. 2001, 125: 241-244. 10.1067/mhn.2001.117874.CrossRefPubMed Pinto JM, Ansley J, Baroody FM: Lack of utility of postoperative chest radiograph in pediatric tracheotomy. Otolaryngol Head Neck Surg. 2001, 125: 241-244. 10.1067/mhn.2001.117874.CrossRefPubMed
6.
go back to reference Faure A, Floccard B, Pilleul F, Faure F, Badinand B, Mennesson N, Ould T, Guillaume C, Levrat A, Benatir F, Allaouchiche B: Multiplanar reconstruction: a new method for the diagnosis of tracheobronchial rupture?. Intensive Care Med. 2007, 33: 2173-2178. 10.1007/s00134-007-0830-9. Epub 2007 Aug 8CrossRefPubMed Faure A, Floccard B, Pilleul F, Faure F, Badinand B, Mennesson N, Ould T, Guillaume C, Levrat A, Benatir F, Allaouchiche B: Multiplanar reconstruction: a new method for the diagnosis of tracheobronchial rupture?. Intensive Care Med. 2007, 33: 2173-2178. 10.1007/s00134-007-0830-9. Epub 2007 Aug 8CrossRefPubMed
7.
go back to reference Moriwaki Y, Sugiyama M, Matsuda G, Toyoda H, Kosuge T, Uchida K, Fukuyama H, Iwashita M, Morimura N, Suzuki J, Yamamoto T, Suzuki N: Usefulness of the 3-dimensionally reconstructed computed tomography imaging for diagnosis of the site of tracheal injury (3D-tracheography). World J Surg. 2005, 29: 102-105. 10.1007/s00268-004-7433-1.CrossRefPubMed Moriwaki Y, Sugiyama M, Matsuda G, Toyoda H, Kosuge T, Uchida K, Fukuyama H, Iwashita M, Morimura N, Suzuki J, Yamamoto T, Suzuki N: Usefulness of the 3-dimensionally reconstructed computed tomography imaging for diagnosis of the site of tracheal injury (3D-tracheography). World J Surg. 2005, 29: 102-105. 10.1007/s00268-004-7433-1.CrossRefPubMed
8.
go back to reference Atkins BZ, Abbate S, Fisher SR, Vaslef SN: Current management of laryngotracheal trauma: case report and literature review. J Trauma. 2004, 56: 185-190. 10.1097/01.TA.0000082650.62207.92.CrossRefPubMed Atkins BZ, Abbate S, Fisher SR, Vaslef SN: Current management of laryngotracheal trauma: case report and literature review. J Trauma. 2004, 56: 185-190. 10.1097/01.TA.0000082650.62207.92.CrossRefPubMed
9.
go back to reference Kawaguchi T, Kushibe K, Takahama M, Taniguchi S: Bluntly traumatic tracheal transection: usefulness of percutaneous cardiopulmonary support for maintenance of gas exchange. Eur J Cardiothorac Surg. 2005, 27: 523-525. 10.1016/j.ejcts.2004.12.021.CrossRefPubMed Kawaguchi T, Kushibe K, Takahama M, Taniguchi S: Bluntly traumatic tracheal transection: usefulness of percutaneous cardiopulmonary support for maintenance of gas exchange. Eur J Cardiothorac Surg. 2005, 27: 523-525. 10.1016/j.ejcts.2004.12.021.CrossRefPubMed
10.
go back to reference Wu MH, Tsai YF, Lin MY, Hsu IL, Fong Y: Complete laryngotracheal disruption caused by blunt injury. Ann Thorac Surg. 2004, 77: 1211-1215. 10.1016/j.athoracsur.2003.08.003.CrossRefPubMed Wu MH, Tsai YF, Lin MY, Hsu IL, Fong Y: Complete laryngotracheal disruption caused by blunt injury. Ann Thorac Surg. 2004, 77: 1211-1215. 10.1016/j.athoracsur.2003.08.003.CrossRefPubMed
11.
go back to reference O’Mara W, Hebert AF: External laryngeal trauma. J La State Med Soc. 2000, 152: 218-222.PubMed O’Mara W, Hebert AF: External laryngeal trauma. J La State Med Soc. 2000, 152: 218-222.PubMed
12.
go back to reference Loh KS, Irish JC: Traumatic complications of intubation and other airway management procedures. Anesthesiol Clin North America. 2002, 20: 953-969. 10.1016/S0889-8537(02)00022-6.CrossRefPubMed Loh KS, Irish JC: Traumatic complications of intubation and other airway management procedures. Anesthesiol Clin North America. 2002, 20: 953-969. 10.1016/S0889-8537(02)00022-6.CrossRefPubMed
13.
go back to reference Almasi M, Andrasovska M, Koval J: Blunt external trauma to the trachea: report of two cases. B-ENT. 2005, 1: 93-96.PubMed Almasi M, Andrasovska M, Koval J: Blunt external trauma to the trachea: report of two cases. B-ENT. 2005, 1: 93-96.PubMed
14.
go back to reference Kurai M, Kondo R, Yoshida K, Hyogotani A, Kobayashi N, Amano J: Tracheobronchial injury. Kyobu Geka. 2006, 59: 996-1000. Article in JapanesePubMed Kurai M, Kondo R, Yoshida K, Hyogotani A, Kobayashi N, Amano J: Tracheobronchial injury. Kyobu Geka. 2006, 59: 996-1000. Article in JapanesePubMed
15.
go back to reference Karmy-Jones R, Wood DE: Traumatic injury to the trachea and bronchus. Thorac Surg Clin. 2007, 17: 35-46. 10.1016/j.thorsurg.2007.03.005.CrossRefPubMed Karmy-Jones R, Wood DE: Traumatic injury to the trachea and bronchus. Thorac Surg Clin. 2007, 17: 35-46. 10.1016/j.thorsurg.2007.03.005.CrossRefPubMed
16.
go back to reference Aouad R, Moutran H, Rassi S: Laryngotracheal disruption after blunt neck trauma. Am J Emerg Med. 2007, 25: 1084-e1-2CrossRefPubMed Aouad R, Moutran H, Rassi S: Laryngotracheal disruption after blunt neck trauma. Am J Emerg Med. 2007, 25: 1084-e1-2CrossRefPubMed
17.
go back to reference Yang XP: Traumatic rupture-separation of cervical segment of trachea in 3 cases. Journal of Traumatic Surgery. 2004, 6: 272-Article in Chinese Yang XP: Traumatic rupture-separation of cervical segment of trachea in 3 cases. Journal of Traumatic Surgery. 2004, 6: 272-Article in Chinese
Metadata
Title
Clinical features and management of closed injury of the cervical trachea due to blunt trauma
Authors
Dong Ye
Zhisen Shen
Yuyuan Zhang
Shijie Qiu
Cheng Kang
Publication date
01-12-2013
Publisher
BioMed Central
DOI
https://doi.org/10.1186/1757-7241-21-60

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