Clinical Analysis Of The Laryngotracheal Injuries Of 32 Cases

OBJECT:To analyze management of laryngotracheal injuries for improving diagnosis and treatment of laryngotracheal injuries and prevention of laryngotracheal stenosis.METHOD:Clinical data of 32 cases with laryngotracheal injuries from October 2000 to september 2007 were retrospectively analyzed,include visit time,etiological factor,injurious position,clinical situation,diagnose and treatment.RESULT:In 32 cases,21 sustained blunt injury and 11 sustained penetrating injury.There were 27 patients(84.4%)visited in 24h.Traffic accident(37.5%)accounted for the most in etiological factor,followed by knife wound(18.8%)as the second.Complex injuries(37%)were to see frequently in Impaired position of laryngotracheal injuries,next were injuries of thyroid cartilage(16%),cervical tracheal damage(16%)and cricoid cartilage(16%).The most common symptoms and sighs included hoarseness or aphonia(93.8%), dyspnea(90.6%),shock(34.4%)and cervical subcutaneous emphysema(25%). Ventilation of patients of dyspneic respiration were improved with tracheotomy after injuries,laryngotracheal stenosis,next pharyngeal fistula,Paralysis of recurrent laryngeal nerve and tracheoesophageal fistula were the most common complications.One patient died in treatment because of severe laryngemphraxis. The rest 31 patients follow up for 2 months to 7 years,and finally 3 cases failed to visit.1 patient isn't able to extubate because of time.27 followed up patients have no aspirated pneumonia happened.The complete recovery rate of swallowing function is 96.3%.And complete recovery rate of respiratory function is 63.0%,of which improvement rate is 88.9%.Voiced function is improved distinctly,of which complete recovery rate is 55.6%,but 2 cases are difficult in communication.3 cases are unable to extubate to this day.2 sustained laryngotracheal stenosis of 13 in early treatment,Otherwise 12 sustained laryngotracheal stenosis of 16 patients in no early treatment.There are statistical significance comparing the two groups with x~2 analysis(p＜0.01)。raxis.CONCLUTION:1.traffic accident is the most common etiological factor in laryngotracheal injuries,followed by Knife Wound.2.tracheotomy is the best method to secure the airway emergently and prevent asphyxia and death, especially the patiens of narrow glottis who have to be made tracheotomy in time to avoid asphyxia suddenly.3.Early proper diagnosis,early treatment is the key for improving curative effect and preventing complications such as laryngotracheal stenosis.