Author(s)
Shreyas G. Krishnapura
Meredith Tabangin
Ari D. Schuman
Layne Singer
Adam Beuchler
Rebecca Howell
Affiliation(s)
University of Cincinnati Medical Center, Cincinnati Children’s hospital, University of Cincinnati School of Medicine
Abstract:
Objectives: External laryngeal fractures are rare. Second, there is an overall lack of long-term follow-up in voice and swallowing outcomes comparing surgical with non-surgical patients with external laryngeal injuries. Herein, we sought to describe and compare surgical and non-surgical cohorts with external laryngeal injury and follow-up after hospital discharge.
Methods: Retrospective chart review of patients seen at a tertiary medical center between 2011 – 2024. All charts with a diagnosis of larynx fracture (ICD 807.5, 807.6, 905.1) or procedure code CPT 31584 were reviewed. Charts were reviewed for age, gender, race, mechanism of injury, treatment method, and subjective/objective repair outcomes (e.g. post-intervention swallow study and nasopharyngoscopy).
Results: 75 patients met inclusion criteria with a median follow-up 68 days (range 0-2248). Mean age (SD) was 46.8 years (14.1) with a majority male (83%, n=62). The most common cause of injury was blunt trauma (80%, n=60). At the time of presentation, 46.7% (n=35) endorsed subjective dysphagia, and 57.3% endorsed dysphonia (n=43). Seven patients required emergent intervention in the form of intubation, awake tracheostomy, or emergent cricothyroidotomy with 27 requiring open reduction and internal fixation (ORIF) of laryngotracheal fractures. Non-operative groups were observed and offered speech and swallow therapy. Between the operative and non-operative groups, there was no significant difference in persistent dysphagia (24.2% vs. 23.7%, p=1.0) or dysphonia (53% vs. 36.8%, p=0.229) outcomes at last follow-up.
Conclusion: Patients with external laryngeal injury are at an increased risk for long-term sequela of dysphagia and dysphonia, regardless of operative or nonoperative acute interventions.