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CT Findings in Laryngeal Trauma and the Clinical Implications

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Abstract

Purpose

Acute traumatic osseous and cartilaginous injuries to the larynx are rare injuries presenting to the emergency department. Despite the low reported incidence, laryngeal trauma carries a high morbidity and mortality. The purpose of this study is to identify fracture and soft tissue injury patterns in laryngeal trauma and explore associations with patient demographics, mechanisms of injury, urgent airway and surgical intervention.

Methods

A retrospective review of patients with laryngeal injury who underwent multidetector computed tomography (MDCT) imaging was performed. The CT findings of laryngeal and hyoid fracture location, fracture displacement, and soft tissue injuries were recorded. Clinical data including patient demographics, mechanisms of injury, frequency of airway and surgical intervention were also recorded. Correlation of imaging characteristics with patient demographics, mechanism of injury and interventions were assessed for statistical significance using χ2 and Fisher’s exact tests.

Results

The median patient age was 40 years old with a strong male predominance. The most common mechanisms of injury included motor vehicle collisions and penetrating gunshot wounds. Thyroid cartilage fractures were the most common fracture type. Findings of fracture displacement and airway hematoma had a higher correlation with requiring urgent airway management.

Conclusion

Radiologists’ early recognition and prompt communication of laryngeal trauma to the clinical service is important to reduce associated morbidity and mortality. Displaced fractures and laryngeal hematomas should be promptly conveyed to the clinical service as they are associated with more complex injuries and higher rates of urgent airway management and surgical intervention.

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Abbreviations

ENT:

Otolaryngology

MDCT:

Multidetector computed tomography

NSGY:

Neurosurgery

PACS:

Picture archiving and communication systems

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Authors and Affiliations

  1. Department of Radiology, Loyola University Medical Center, 2160 S. 1st Avenue, 60153, Maywood, IL, USA

    Gianna N. DiGrazia, Serra L. Aktan, Emma M. Sechrist, Justina Rehn, Cara Joyce & Mariah H. Siddiqui

Authors
  1. Gianna N. DiGrazia
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  2. Serra L. Aktan
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  3. Emma M. Sechrist
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  4. Justina Rehn
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  5. Cara Joyce
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  6. Mariah H. Siddiqui
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Corresponding author

Correspondence to Gianna N. DiGrazia.

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Conflict of interest

G.N. DiGrazia, S.L. Aktan, E.M. Sechrist, J. Rehn, C. Joyce and M.H. Siddiqui declare that they have no competing interests.

Ethical standards

Ethical approval was waived by the local Ethics Committee of Loyola University Medical Center in view of the retrospective nature of the study and all the procedures being performed were part of the routine care. Informed consent was not obtained from all individual participants included in the study due to the retrospective design.

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DiGrazia, G.N., Aktan, S.L., Sechrist, E.M. et al. CT Findings in Laryngeal Trauma and the Clinical Implications. Clin Neuroradiol 33, 1123–1131 (2023). https://doi.org/10.1007/s00062-023-01323-w

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  • DOI: https://doi.org/10.1007/s00062-023-01323-w

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