Two cases of tracheal disruption due to blunt trauma.

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A 20-year-old man (case 1) was admitted due to a traffic accident. Chest CT demonstrated subcutaneous and mediastinal emphysema. Emergent bronchoscopy suggested tracheal laceration, and an endotracheal tube was intubated beyond the tear. Conservative therapy was selected because subcutaneous emphysema and dyspnea became decreased. On the 3rd day, bronchoscopy was again performed and revealed perforation of the trachea, for which an operation was conducted. This tracheal defect was covered with an anterior cervical muscle flap.rAt this operation, we mistook the dislocation of the arytenoid cartilage. After operation, vocal cord was adhesive, and 5 months later, laryngoplasty was performed and a silicone implant was placed in the laryngeal space to prevent stenosis.<BR>The second case was a 55-year-old man, who was admitted for hoarseness following blunt trauma by a rope while driving his motor bicycle. Laryngoscopy showed bilateral recurrent nerve palsy, but bronchoscopy was not carried out, and his tracheal injury could not be confirmed. On the seventh day after admission, his dyspnea gradually increased and tracheotomy was scheduled. At induction of anesthesia, the endotracheal tube damaged the trachea, and so tracheal reconstruction was performed. We misunderstood his tracheal injury until this operation.<BR>Whenever we evaluate patients with blunt neck trauma, more careful examination of bronchoscopy is necessary to confirm the tracheobronchial and laryngeal disruptions. Early surgical treatment to maintain laryngeal functions is important to improve the quality of life.
特定非営利活動法人日本呼吸器外科学会の論文

Two cases of tracheal disruption due to blunt trauma.

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