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Management of Laryngotracheal and Tracheobronchial Injuries

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Author(s): Hamid Reza Davari

Journal: Iranian Journal of Medical Sciences
ISSN 0253-0716

Volume: 35;
Issue: 3;
Start page: 242;
Date: 2010;
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Keywords: Trauma | Larynx | Trachea | Bronchi | Intubation

ABSTRACT
Laryngotracheal and tracheobronchial injuries are uncommon,and their successful diagnosis and management often require ahigh level of expertise. This paper aimed at retrospectiveanalysis of a thoracic surgeon's experience in the diagnosisand management of traumatic injuries to the larynx, tracheaand major bronchi. Forty one patients with major airwaytrauma were managed from March 1994 to November 2008.Their demographic characteristics including age, gender,mechanisms and locations of injuries, associated other organinjuries as well as surgical airway managements and the outcomeswere recorded. Seven patients had re-implantation ofthe main bronchus, and one patient had a repair of the rightupper lobe bronchus with concomitant bilobectomy. In casesof tracheal injury, 16 patients had a primary repair of trachea.However, seven patients with tracheal injury first conservativeapproaches, but 4 of them were later subjected to sleeve resectionof trachea. In patients with laryngotracheal injuries, and ina patient with thermal injury, Montgomery T-Tube was usedwith or without repair and/or reconstruction. Four patients died,but no significant morbidity was seen in others. The analysis ofthe cases suggests that laryngotracheal and tracheobronchialinjuries require early correct diagnosis, skillful management,and prompt individualized surgical airway repair.
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