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Laryngeal reconstruction following shrapnel injury in a British soldier: case report

Published online by Cambridge University Press:  03 April 2008

N Sharma*
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Birmingham NHS Trust, UK
M De
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Birmingham NHS Trust, UK
T Martin
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Birmingham NHS Trust, UK
P Pracy
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Birmingham NHS Trust, UK
*
Address for correspondence: Mr Neil Sharma, Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Birmingham NHS Trust, Birmingham B15 2TH, UK. E-mail: [email protected]

Abstract

Introduction:

Laryngeal injuries are uncommon but result in high mortality and morbidity rates when they do occur. We report a case of laryngeal fracture due to penetrating shrapnel injury, repaired with miniplates.

Case report:

A 26-year-old soldier was involved in an explosion and sustained a shrapnel wound to his right neck. After immediate airway management at the field hospital he was transferred to the UK, where he underwent a neck exploration, laryngofissure and repair of the thyroid cartilage using miniplates. An endolaryngeal stent was placed, which was removed at a second operation seven days later. Post-operatively, the patient recovered well and his voice improved rapidly. Six months post-operatively, he returned to work.

Discussion:

The cause and nature of laryngeal injury differs between wartime and peacetime. The methods of diagnosis and management strategies are reviewed. The early recognition of injury and protection of the airway are of paramount importance when dealing with laryngeal injury. Delayed laryngeal reconstruction using miniplates can give a good functional result.

Type
Clinical Records
Copyright
Copyright © JLO (1984) Limited 2008

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