Abstract
To summarize and describe the clinical presentations, diagnostic
approaches, and airway management techniques in children with
laryngotracheal (LT) trauma. Methods: We retrospectively reviewed
clinical data related to LT trauma diagnosed and treated at XXX
Children’s Hospital between January 2013 and July 2018. Disease
diagnosis, treatment, management, and outcomes were detailed. Results: A
total of 13 cases were enrolled, with an average age 6 years, 9 months.
There were seven cases of penetrating LT trauma, of which four cases
were injured by knife stabbings and three by dog bites. Tracheostomy was
performed for two of these patients, and one with persistent left vocal
cord paralysis. The six cases of blunt LT trauma were caused by knocking
on hard objects. Two of these six patients underwent tracheostomy. One
case had a dislocation of the cricoarytenoid joint and underwent a
closed reduction surgery. In all cases, voice, airway, and swallowing
outcomes were graded as good, except for one patient who had residual
paralysis of the vocal cords. Conclusion: We have summarized a large
series of pediatric LT trauma cases. In our experience, examinations by
flexible fiberoptic laryngoscopy and computed tomography imaging can
play important roles in the diagnostic approach to LT trauma. In
addition, the airway should be kept safe and, if necessary, opened by
tracheal intubation or tracheotomy. We have proposed our own
recommendations for managing pediatric LT trauma cases in order to
inform the development of standardized clinical guidelines.