Humans ; Laryngoscopy ; adverse effects ; Larynx ; injuries

Adult ; Humans ; Laryngostenosis ; surgery ; Larynx ; injuries ; Male ; Trachea ; injuries ; Tracheal Stenosis ; surgery ; Wounds and Injuries ; surgery

Penetrating neck trauma present difficult management issues by virtue of their rarity. Undiagnosed laryngotracheal injuries have serious implications, especially in the context of multiple trauma, where other injuries overshadow that of the laryngotracheal complex. This is a case of a schizophrenic patient with multiple self-inflicted cuts on his throat and abdomen. Injuries include open, comminuted laryngeal complex lacerations with vocal cord avulsion, as well as evisceration of small bowel. Adequate assessment using both direct laryngoscopy and rigid endoscopy, coupled with open exploration, allowed optimal exposure and fixation of the larynx in the anatomical configuration. The post-operative outcome of the airway and voice remained satisfactory at follow-up. A high index of suspicion coupled with adequate surgical approach allowed establishment of a functional larynx.
Larynx/*injuries ; Schizophrenia/complications ; *Self-Injurious Behavior ; Trachea/*injuries ; Vocal Cords/*injuries ; Wounds, Penetrating/*surgery

OBJECTIVE: To explore the management of the laryngeal injury. METHOD: The forty five patients of laryngeal injury had been rescued. Twenty eight patients were treated with the tracheotomy and twenty four patients of them were treated with the laryngoplasty. RESULT: All the patients were survived. Tracheostomy tube of twenty eight patients was taken away without the cicatricial structure of larynx. CONCLUSION With the reasonable management after the laryngeal injury, the injury could be cured in time without complications.
Adolescent ; Adult ; Aged ; Female ; Humans ; Larynx ; injuries ; Male ; Middle Aged ; Neck Injuries ; surgery ; Young Adult

BACKGROUND: The management of penetrating neck injuries presents a difficult problem. Although many authors have stated that surgical exploration should be mandatory for all neck injuries that penetrate platysma, recent reports from many centers now claim selective exploration. The aim of this study was to review a policy of selective neck exploration based on clinical presentation, anatomic location, and the result of diagnostic studies. METHOD: We reviewed retrospectively medical records of 66 patients who were admitted and managed at Yongdong Severance hospital, Yonsei university college of medicine due to penetrating neck injuries from Jan. 1990 to Dec. 1996. RESULTS: Forty-one patients(62%) were underwent immediate neck exploration, while the remaining 25 patients(38%) were admitted and observed. Three had esophagoscopy, four had esophagogram, and three had direct laryngoscopy, all of which revealed normal result except one patient had blood tinged larynx on laryngoscopy. Results of 12 neck explorations(29%) were negative. There was no delayed diagnosis during conservative treatment. There was no mortality. CONCLUSION: We concluded that selective exploration of penetrating neck injuries is both safe and resonable.
Delayed Diagnosis ; Esophagoscopy ; Humans ; Laryngoscopy ; Larynx ; Medical Records ; Mortality ; Neck Injuries* ; Neck* ; Retrospective Studies ; Tolnaftate

Phonatory and swallowing symptoms after thyroidectomy are well-known implications of laryngeal nerve injuries. The laryngeal nerve injuries, superior and inferior, are major complication that results in changes both to voice quality and production of high-pitched sounds, which is of utmost importance for voice professionals. However, these functional and subjective voice and swallowing symptoms were often neglected by clinicians. Most voice and swallowing alterations after thyroidectomy are self limited and are not related to demonstrable impaired nerves function. Several causes have been supposed to interpret these symptoms. They have been attributed to arytenoid trauma after endotracheal intubation, surgical trauma, modification of the vascular supply of the larynx, local pain in the neck, cricothyroid dysfunction, strap muscle mal-function, laryngotracheal fixation with impairment of vertical movement, and psychologic reaction to the operation. Because of the impact of patient's perception on postoperative outcome in recent years, some groups have extensively investigated this functional post-thyroidectomy syndrome. All the published studies demonstrate that most patients who undergo thyroidectomy have at least some subjective vocal and/or swallowing complaints early after the opera-tion. Despite increasing interest, prospective data about the long-term outcomes of functional postthyroidectomy syndrome are lacking. This paper is to review the long-term trend and evolution of voice and swallowing symptoms after thyroidectomy in the absence of laryngeal nerve injury.
Deglutition ; Humans ; Intubation, Intratracheal ; Laryngeal Nerve Injuries ; Larynx ; Neck ; Thyroidectomy ; Voice ; Voice Quality

Intubation may lead to several dental complications. Furthermore, a tooth damaged during intubation may be subsequently dislocated. In the present case, the upper primary incisor was avulsed during intubation and, unbeknownst to the anesthesiologist, displaced to the larynx. We report here on the findings and indicate appropriate treatment. Intubation for general anesthesia in children can result in tooth damage and/or dislocation of primary teeth with subsequent root resorption. Prevention is key, and thus it is critical to evaluate the patient's dental status before and after intubation. Furthermore, anesthesiologists and dentists should pay close attention to this risk to prevent any avulsed, dislocated, or otherwise displaced teeth from remaining undetected and subsequently causing serious complications.
Anesthesia ; Anesthesia, General ; Child ; Dentists ; Dislocations ; Humans ; Hypopharynx* ; Incisor ; Intubation ; Intubation, Intratracheal* ; Larynx ; Root Resorption ; Tooth ; Tooth Injuries ; Tooth, Deciduous*

OBJECTIVETo evaluate different methods to explose recurrent laryngeal nerve (RLN) based on the location of thyroid diseses and anatomic path of the RLN, to avoid the RLN damage in thyroid surgery.

METHODSA total of 755 cases underwent total lobectomy was studied retrospectively. RLN was explosed in each case.

RESULTSA total of 963 RLN was exposed in 755 cases, among those 658 RLN were exposed by lateral approach, 106 by inferior approach, and 199 by superior approach. It was showed that 694 RLN traveled deep to the inferior throid artery and 119 superficial to the artery, 98 through between two branches of the artery, and 62 with the cross of the nerve branches and the artery branches. Before entering larynx, 578 RLN gave off branches and 385 had no branches. Non-recurrent laryngeal nerves were found in 2 cases. There were 6 cases who presented with hoarseness after thyroidectomy and undergoing reexploration, among them RLN were legated in 4 cases and severed in 2 cases.

CONCLUSIONSThe anatomic relation of RLN is relatively complicated. Lateral, inferior or superior aproach may be used for exposure of RLN to decrease risks of injury to the nerve.

Arteries ; Hoarseness ; Larynx ; Recurrent Laryngeal Nerve ; surgery ; Recurrent Laryngeal Nerve Injuries ; prevention & control ; Retrospective Studies ; Thyroid Gland ; surgery ; Thyroidectomy

OBJECTIVE: To explore the extralaryngeal furcation variation of the recurrent laryngeal nerve (RLN) in total thyroidectomy. METHOD: The clinical data of 216 RLNs from 108 patients undergone total thyroidectomy were retrospectively analyzed. RESULT: RLN was found during every operation and exposed in whole course until access into larynx. Twenty (9.26%) pieces of RLNs showed bifurcated or trifurcated RLNs before access into larynx. Ratio of furcation is lower than that reported before internationally. Bifurcations of RLNs on the left were more than that on the right. CONCLUSION The protection of RLN is important for thyroid operation, especially in total thyroidetomy. Variation of extralaryngeal furcation of RLN usually leads to injury of RLN. Understanding of variation of RLN could decrease nerve function related complication.
Humans ; Larynx ; Recurrent Laryngeal Nerve ; pathology ; Recurrent Laryngeal Nerve Injuries ; diagnosis ; Retrospective Studies ; Thyroid Gland ; surgery ; Thyroidectomy

OBJECTIVE: To explore a method for the repairment of laryngeal fistula following electrical burn. METHOD: Sternocleidomastoid myocutaneous flap was applied to restore laryngeal fistula following electrical injuries. RESULT: The patient was cured with good repairment of cutaneous defect and laryngeal function following operation. CONCLUSION Application of neighboring myocutaneous flap is beneficial for the reconstruction of damaged tissue.
Adult ; Burns, Electric ; surgery ; Fistula ; etiology ; surgery ; Humans ; Larynx ; injuries ; Male ; Muscle, Skeletal ; transplantation ; Reconstructive Surgical Procedures ; Surgical Flaps