Clinical characteristics,diagnosis and treatment features of 49 cases of laryngotracheal rup-ture injury

Chen Guanyin; Liang Leping; Zhao Qianqian; Shi Jingxuan; Zhao Daqing; Bian Ka; Lu Lianjun

doi:10.3969/j.issn.1009-4237.2025.11.006

Abstract：Objective To explore the clinical characteristics,diagnosis and treatment features of laryngotra-cheal rupture caused by trauma,and to improve the understanding and management ability of this injury.Methods A retrospective analysis was conducted on the clinical data of 49 patients with laryngotracheal rupture admitted to Tangdu Hospital of Air Force Medical University from Jan.2015 to Dec.2024.The cervical injury conditions,ima-ging data,treatment measures and prognosis were analyzed.Results A total of 49 patients were included in this study,with ages ranging from 6 to 87 years and an average age of 46.1 years.There were 33 males and 16 females.The causes of injury were 6 cases of strangulation,9 cases of blunt impact injury,and 34 cases of incised wound.Ac-cording to the trauma type,there were 11 cases of closed laryngotracheal rupture and 38 cases of open laryngotrache-al rupture.All patients were complicated with cervical and mediastinal emphysema and bilateral pulmonary inflam-mation.Among the 11 patients with closed laryngotracheal rupture,8 cases had tracheal transection,9 cases had dyspnea,and all the 9 patients underwent emergency tracheotomy;2 cases had hemorrhagic anemia,and both re-ceived blood transfusion therapy;4 cases received T-tube placement during operation to support the collapsed air-way;7 cases had recurrent laryngeal nerve injury;1 case underwent partial resection of the unilateral vocal cord due to postoperative bilateral vocal cord paralysis and then successfully extubated;1 case achieved normal breathing after bronchoscopic balloon dilatation for tracheal anastomotic scar formation.Finally,10 cases were extubated,while 1 case failed to be extubated due to re-transection of the tracheal and esophageal anastomoses,complicated by infection and granulation tissue formation.Among 38 patients with open laryngotracheal rupture,21 cases had laryngeal tran-section,9 cases had dyspnea,and all the 9 patients underwent emergency tracheotomy;14 cases had hemorrhagic a-nemia,and all received blood transfusion therapy;4 cases received T-tube or finger cot placement during operation to support the collapsed airway;4 cases had recurrent laryngeal nerve injury.Finally,36 cases were extubated,1 case died of severe pulmonary infection complicated by tracheoesophageal fistula,and 1 case was lost to follow-up.Conclusion Laryngotracheal rupture has a wide age range.Open laryngotracheal rupture is more common than closed type,and incised wound is the main cause of injury.In closed laryngotracheal rupture,tracheal rupture is more common,and the incidence rates of dyspnea,airway collapse and recurrent laryngeal nerve injury are high.In open laryngotracheal rupture,laryngeal rupture is more common,and the incidence rate of hemorrhagic anemia is high.Pa-tients with laryngotracheal rupture complicated by esophageal rupture,scar formation or severe pulmonary infection have a poor prognosis.