| 1 |
Flexible fiber optic laryngoscopy |
Generally medically managed and do not require surgical intervention. Helpful adjunctive medical treatments include steroids, antibiotics, humidification, voice rest |
| 2 |
Direct laryngoscopy and esophagoscopy |
Serial examinations, since the injuries may worsen over time. These injuries infrequently require a tracheostomy. Helpful adjunctive medical treatments as described above |
| 3 |
Direct laryngoscopy and esophagoscopy performed in the operating room |
Tracheostomy and surgical repair are often required. The following injuries of the larynx require surgical repair: disruption of the anterior commissure, major endolaryngeal lacerations, vocal cord tear, immobile vocal cord, cartilage exposure, displaced cartilage fractures |
| 4 |
Direct laryngoscopy and esophagoscopy performed in the operating room |
Tracheostomy is always required |
| Surgical repair requires stent placement to maintain the integrity of the larynx |
| 5 |
These patients present in severe respiratory distress and therefore endoscopic evaluation is delayed until an airway is secured |
Disruption of the airway usually occurs above or below the cricoid cartilage, either at the cricothyroid membrane or cricotracheal junction (Figures 1,2). The airway is usually temporarily established using an endotracheal tube inserted through the neck directly into trachea distal to the site of transection (Figure 3). A complex laryngotracheal repair is then performed through a low cervical incision (Figure 4) |
