Laryngeal Trauma: Current Evidence in Clinical and Surgical Management

Abstract

Introduction: Laryngeal trauma is an infrequent but potentially life-threatening injury. Timely diagnosis is crucial to avoid lethal complications and serious functional sequelae such as permanent dysphonia, laryngotracheal stenosis, and chronic respiratory difficulties. This clinical entity requires high diagnostic suspicion and systematic management due to its variable clinical presentation.

Objective: To analyze in detail the current epidemiological, clinical, and therapeutic aspects of laryngeal trauma, identifying factors that influence patient outcomes, and highlighting the importance of a multidisciplinary approach in managing this condition.

Methods: A narrative review was performed through a systematic search in electronic databases, selecting studies reporting epidemiology, diagnosis, and management of laryngeal trauma, as well as current therapeutic strategies. Prospective clinical studies, retrospective studies, and case series were primarily included.

Results: Thirty relevant studies were included. The most common causes of laryngeal trauma were motor vehicle accidents and penetrating injuries secondary to interpersonal violence. Early diagnosis was supported by flexible laryngoscopy and computed tomography. The most used classification system was the Schaefer-Fuhrman classification, with frequent grade III and IV lesions requiring early surgical intervention to secure the airway and reduce respiratory complications. The main predictive factors for surgical intervention included inspiratory stridor, significant subcutaneous emphysema, displaced cartilaginous fractures, and severe neurological impairment.

Conclusions: Laryngeal trauma requires timely diagnosis and management to avoid severe complications. Early identification of risk factors and multidisciplinary intervention are key to significantly improving outcomes and the functional recovery of these patients.