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Laryngotracheal disruption from blunt pediatric neck injuries: Impact of early recognition and intervention on outcome
• Blunt and penetrating neck injuries are an infrequent cause of morbidity and mortality in the pediatric population. Although less common than penetrating injuries, blunt pediatric neck injuries are more often life-threatening because of associated laryngotracheal disruption. The authors reviewed t...
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| Published in: | Journal of pediatric surgery 1995-02, Vol.30 (2), p.331-335 |
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| Language: | English |
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| container_end_page | 335 |
| container_issue | 2 |
| container_start_page | 331 |
| container_title | Journal of pediatric surgery |
| container_volume | 30 |
| creator | Ford, Henri R Gardner, Mary J Lynch, James M |
| description | • Blunt and penetrating neck injuries are an infrequent cause of morbidity and mortality in the pediatric population. Although less common than penetrating injuries, blunt pediatric neck injuries are more often life-threatening because of associated laryngotracheal disruption. The authors reviewed their experience with pediatric neck injuries over the past 5 years. There were nine blunt and 14 penetrating injuries, representing 0.5% of the trauma admissions. There was no significant difference in age or gender distribution between the two groups. Blunt pediatric neck injuries were more often associated with frank respiratory distress at the time of presentation. Massive subcutaneous emphysema and hoarseness were the most common symptoms encountered. All patients with blunt injury underwent direct laryngoscopy and bronchoscopy (DL & B) and esophagoscopy. DL & B results were positive for eight patients; seven patients underwent neck exploration and successful repair of the laryngotracheal injuries. There were two deaths; one of these patients had laryngeal transection, which was not recognized at the time of DL & B. The other death resulted from associated tracheobronchial disruption secondary to massive blunt chest trauma. The patients with penetrating neck injuries were more likely to be treated nonoperatively, to have a shorter stay in the hospital and intensive care unit, and to have a lower injury severity score. There were no deaths in this group. The authors conclude that all patients with blunt neck trauma should undergo emergent and meticulous DL & B. Visualization of laryngotracheal disruption mandates immediate neck exploration and primary repair. |
| doi_str_mv | 10.1016/0022-3468(95)90584-7 |
| format | article |
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Although less common than penetrating injuries, blunt pediatric neck injuries are more often life-threatening because of associated laryngotracheal disruption. The authors reviewed their experience with pediatric neck injuries over the past 5 years. There were nine blunt and 14 penetrating injuries, representing 0.5% of the trauma admissions. There was no significant difference in age or gender distribution between the two groups. Blunt pediatric neck injuries were more often associated with frank respiratory distress at the time of presentation. Massive subcutaneous emphysema and hoarseness were the most common symptoms encountered. All patients with blunt injury underwent direct laryngoscopy and bronchoscopy (DL & B) and esophagoscopy. DL & B results were positive for eight patients; seven patients underwent neck exploration and successful repair of the laryngotracheal injuries. There were two deaths; one of these patients had laryngeal transection, which was not recognized at the time of DL & B. The other death resulted from associated tracheobronchial disruption secondary to massive blunt chest trauma. The patients with penetrating neck injuries were more likely to be treated nonoperatively, to have a shorter stay in the hospital and intensive care unit, and to have a lower injury severity score. There were no deaths in this group. The authors conclude that all patients with blunt neck trauma should undergo emergent and meticulous DL & B. Visualization of laryngotracheal disruption mandates immediate neck exploration and primary repair.</description><identifier>ISSN: 0022-3468</identifier><identifier>EISSN: 1531-5037</identifier><identifier>DOI: 10.1016/0022-3468(95)90584-7</identifier><identifier>PMID: 7738760</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adolescent ; Airway Obstruction - diagnosis ; Airway Obstruction - etiology ; Airway Obstruction - surgery ; Bicycling - injuries ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Hoarseness - etiology ; Humans ; Infant ; Intubation, Intratracheal ; Larynx - injuries ; Male ; Neck - surgery ; Neck Injuries ; Subcutaneous Emphysema - etiology ; Time Factors ; Trachea - injuries ; Tracheostomy ; Wounds, Nonpenetrating - complications ; Wounds, Nonpenetrating - diagnosis ; Wounds, Nonpenetrating - therapy ; Wounds, Penetrating</subject><ispartof>Journal of pediatric surgery, 1995-02, Vol.30 (2), p.331-335</ispartof><rights>1995</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c357t-b6cd759807f31cabfb2fd486c50582034cf1dee4a411f8dc3a8f55e31b35bfb33</citedby><cites>FETCH-LOGICAL-c357t-b6cd759807f31cabfb2fd486c50582034cf1dee4a411f8dc3a8f55e31b35bfb33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,786,790,27957,27958</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/7738760$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ford, Henri R</creatorcontrib><creatorcontrib>Gardner, Mary J</creatorcontrib><creatorcontrib>Lynch, James M</creatorcontrib><title>Laryngotracheal disruption from blunt pediatric neck injuries: Impact of early recognition and intervention on outcome</title><title>Journal of pediatric surgery</title><addtitle>J Pediatr Surg</addtitle><description>• Blunt and penetrating neck injuries are an infrequent cause of morbidity and mortality in the pediatric population. Although less common than penetrating injuries, blunt pediatric neck injuries are more often life-threatening because of associated laryngotracheal disruption. The authors reviewed their experience with pediatric neck injuries over the past 5 years. There were nine blunt and 14 penetrating injuries, representing 0.5% of the trauma admissions. There was no significant difference in age or gender distribution between the two groups. Blunt pediatric neck injuries were more often associated with frank respiratory distress at the time of presentation. Massive subcutaneous emphysema and hoarseness were the most common symptoms encountered. All patients with blunt injury underwent direct laryngoscopy and bronchoscopy (DL & B) and esophagoscopy. DL & B results were positive for eight patients; seven patients underwent neck exploration and successful repair of the laryngotracheal injuries. There were two deaths; one of these patients had laryngeal transection, which was not recognized at the time of DL & B. The other death resulted from associated tracheobronchial disruption secondary to massive blunt chest trauma. The patients with penetrating neck injuries were more likely to be treated nonoperatively, to have a shorter stay in the hospital and intensive care unit, and to have a lower injury severity score. There were no deaths in this group. The authors conclude that all patients with blunt neck trauma should undergo emergent and meticulous DL & B. Visualization of laryngotracheal disruption mandates immediate neck exploration and primary repair.</description><subject>Adolescent</subject><subject>Airway Obstruction - diagnosis</subject><subject>Airway Obstruction - etiology</subject><subject>Airway Obstruction - surgery</subject><subject>Bicycling - injuries</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Hoarseness - etiology</subject><subject>Humans</subject><subject>Infant</subject><subject>Intubation, Intratracheal</subject><subject>Larynx - injuries</subject><subject>Male</subject><subject>Neck - surgery</subject><subject>Neck Injuries</subject><subject>Subcutaneous Emphysema - etiology</subject><subject>Time Factors</subject><subject>Trachea - injuries</subject><subject>Tracheostomy</subject><subject>Wounds, Nonpenetrating - complications</subject><subject>Wounds, Nonpenetrating - diagnosis</subject><subject>Wounds, Nonpenetrating - therapy</subject><subject>Wounds, Penetrating</subject><issn>0022-3468</issn><issn>1531-5037</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1995</creationdate><recordtype>article</recordtype><recordid>eNp9kE1r3DAQhkVpSTYf_6ABnUpycCNZluXtIRBC8wELubRnIUujVKktuZK8kH9feXfJMSAQzDzvDPMg9JWS75TQ9pqQuq5Y03aXa361JrxrKvEJrShntOKEic9o9Y4co5OUXgkpZUKP0JEQrBMtWaHtRsU3_xJyVPoPqAEbl-I8ZRc8tjGMuB9mn_EExqkcncYe9F_s_OscHaQf-GmclM44WAwqDm84gg4v3u3yyptCZohb8LvC8uaswwhn6ItVQ4Lzw3-Kft___HX3WG2eH57ubjeVZlzkqm-1EXzdEWEZ1aq3fW1N07Wal3NrwhptqQFoVEOp7YxmqrOcA6M94wVm7BR928-dYvg3Q8pydEnDMCgPYU5SiJqX7AI2e1DHkFIEK6foxuJGUiIX3XJxKReXcs3lTrcUJXZxmD_3I5j30MFv6d_s-1CO3DqIMmkHXhedxVSWJriPF_wHcUiSJQ</recordid><startdate>19950201</startdate><enddate>19950201</enddate><creator>Ford, Henri R</creator><creator>Gardner, Mary J</creator><creator>Lynch, James M</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19950201</creationdate><title>Laryngotracheal disruption from blunt pediatric neck injuries: Impact of early recognition and intervention on outcome</title><author>Ford, Henri R ; Gardner, Mary J ; Lynch, James M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c357t-b6cd759807f31cabfb2fd486c50582034cf1dee4a411f8dc3a8f55e31b35bfb33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1995</creationdate><topic>Adolescent</topic><topic>Airway Obstruction - diagnosis</topic><topic>Airway Obstruction - etiology</topic><topic>Airway Obstruction - surgery</topic><topic>Bicycling - injuries</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Hoarseness - etiology</topic><topic>Humans</topic><topic>Infant</topic><topic>Intubation, Intratracheal</topic><topic>Larynx - injuries</topic><topic>Male</topic><topic>Neck - surgery</topic><topic>Neck Injuries</topic><topic>Subcutaneous Emphysema - etiology</topic><topic>Time Factors</topic><topic>Trachea - injuries</topic><topic>Tracheostomy</topic><topic>Wounds, Nonpenetrating - complications</topic><topic>Wounds, Nonpenetrating - diagnosis</topic><topic>Wounds, Nonpenetrating - therapy</topic><topic>Wounds, Penetrating</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ford, Henri R</creatorcontrib><creatorcontrib>Gardner, Mary J</creatorcontrib><creatorcontrib>Lynch, James M</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of pediatric surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ford, Henri R</au><au>Gardner, Mary J</au><au>Lynch, James M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Laryngotracheal disruption from blunt pediatric neck injuries: Impact of early recognition and intervention on outcome</atitle><jtitle>Journal of pediatric surgery</jtitle><addtitle>J Pediatr Surg</addtitle><date>1995-02-01</date><risdate>1995</risdate><volume>30</volume><issue>2</issue><spage>331</spage><epage>335</epage><pages>331-335</pages><issn>0022-3468</issn><eissn>1531-5037</eissn><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><abstract>• Blunt and penetrating neck injuries are an infrequent cause of morbidity and mortality in the pediatric population. Although less common than penetrating injuries, blunt pediatric neck injuries are more often life-threatening because of associated laryngotracheal disruption. The authors reviewed their experience with pediatric neck injuries over the past 5 years. There were nine blunt and 14 penetrating injuries, representing 0.5% of the trauma admissions. There was no significant difference in age or gender distribution between the two groups. Blunt pediatric neck injuries were more often associated with frank respiratory distress at the time of presentation. Massive subcutaneous emphysema and hoarseness were the most common symptoms encountered. All patients with blunt injury underwent direct laryngoscopy and bronchoscopy (DL & B) and esophagoscopy. DL & B results were positive for eight patients; seven patients underwent neck exploration and successful repair of the laryngotracheal injuries. There were two deaths; one of these patients had laryngeal transection, which was not recognized at the time of DL & B. The other death resulted from associated tracheobronchial disruption secondary to massive blunt chest trauma. The patients with penetrating neck injuries were more likely to be treated nonoperatively, to have a shorter stay in the hospital and intensive care unit, and to have a lower injury severity score. There were no deaths in this group. The authors conclude that all patients with blunt neck trauma should undergo emergent and meticulous DL & B. Visualization of laryngotracheal disruption mandates immediate neck exploration and primary repair.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>7738760</pmid><doi>10.1016/0022-3468(95)90584-7</doi><tpages>5</tpages></addata></record> |
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| ispartof | Journal of pediatric surgery, 1995-02, Vol.30 (2), p.331-335 |
| issn | 0022-3468 1531-5037 |
| language | eng |
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| source | ScienceDirect Freedom Collection |
| subjects | Adolescent Airway Obstruction - diagnosis Airway Obstruction - etiology Airway Obstruction - surgery Bicycling - injuries Child Child, Preschool Female Follow-Up Studies Hoarseness - etiology Humans Infant Intubation, Intratracheal Larynx - injuries Male Neck - surgery Neck Injuries Subcutaneous Emphysema - etiology Time Factors Trachea - injuries Tracheostomy Wounds, Nonpenetrating - complications Wounds, Nonpenetrating - diagnosis Wounds, Nonpenetrating - therapy Wounds, Penetrating |
| title | Laryngotracheal disruption from blunt pediatric neck injuries: Impact of early recognition and intervention on outcome |
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