The voice of injury: a case report of isolated trauma to the larynx

Although uncommon, laryngotracheal injuries carry a significant risk of mortality. This rare case of isolated laryngeal injury underscores the importance of recognizing the various potential presentations of such injuries and highlights the evidence-based management strategies that every emergency physician should consider when treating potential airway trauma. A 45-year-old male motorcyclist was involved in a road traffic accident during the night and presented to the emergency department the following morning. The patient complained of breathlessness, neck pain, hoarseness of voice, and noisy breathing. Examination revealed stridor, swelling in zones 1 and 2 of the neck, tenderness over the thyroid, and subcutaneous emphysema over the neck and anterior chest. A definitive airway was secured, and computed tomography imaging revealed a fracture of the thyroid cartilage. The patient was managed conservatively, extubated after 1 week, and discharged after 2 days of observation. Classification of the type of injury and the use of an algorithmic approach, involving consensus among the emergency department, trauma surgeons, and the critical care team, can help streamline and standardize management of these cases. Furthermore, a thorough understanding of the dos and don’ts in securing the airway in patients with laryngotracheal injuries increases the robustness of the approach to managing this patient population.