Case report
Transglottic high frequency jet ventilation for management of laryngeal fracture associated with air bag deployment injury

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Abstract

Blunt laryngeal trauma is an uncommon injury associated with high prehospital mortality. Conventional airway management consists of awake tracheostomy. A case of laryngeal trauma associated with air bag deployment managed with tubeless suspension laryngoscopy with high frequency transglottic jet ventilation is presented. The advantages of this technique in the management of patients who are not good candidates for awake tracheostomy are discussed.

Section snippets

Case report

A 19-year-old, African American woman with a medical history significant for asthma and mitral valve prolapse presented to the emergency department as an unrestrained passenger in a single vehicle, head-on motor vehicle collision. Injuries included blunt neck trauma presumed to be from air bag deployment. Symptoms included a hoarse voice and 10/10 tenderness in the anterior laryngeal region. The patient denied chest pain and shortness of breath. Physical examination was notable for a 4-cm

Discussion

Blunt trauma to the larynx is an uncommon, often fatal injury. Prehospital mortality may approach 80% in blunt trauma involving the trachea [1]. Injuries to the trachea are more commonly seen in the lower trachea, and the mortality from these injuries has decreased dramatically from 36% before 1950 to 9% since 1970 [2]. Injuries to the larynx and cervical trachea are commonly associated with maxillofacial and cervical spine injuries [3]. Collateral injuries were not seen in this patient,

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