Chapter 67 - Laryngeal and Esophageal Trauma

Question 1

Most common symptom of laryngeal trauma

Answer 1

Hoarseness

Dysphagia -> pain -> dyspnea -> hemoptysis

Question 2

Preferred method of airway control in laryngeal trauma

Answer 2

Tracheotomy

Endotracheal intubation may exacerbate the injury and precipitate total airway obstruction

Question 3

Laryngeal trauma classification

Answer 3

Schaefer-Fuhrman system or

Lee-Eliashar system

Question 4

Schaefer-Fuhrman system

Answer 4

Group 1: Minor endolaryngeal hematomas; no detectable fracture
Group 2: Edema, hematoma, minor mucosal disruption without exposed cartilage; nondisplaced fracture; varying degrees of airway compromise
Group 3: Massive edema, large mucosal lacerations, exposed cartilage; displaced fracture(s); vocal cord immobility
Group 4: Same as group 3 but more severe with:
Severe mucosal disruption
Disruption of the anterior commissure
Unstable fracture, 2 or more fracture lines
Group 5: Complete laryngotracheal separation

Question 5

NEXUS Criteria for cervical spine imaging in trauma patients

Answer 5

1. No posterior midline cervical tenderness
2. No evidence of intoxication
3. Normal level of alertness
4. No focal neurologic deficit
5. No painful distracting injuries
   * Cervical spine xray indicated unless the patient exhibits ALL listed criteria