Trauma laríngeo externo y fractura de cartílago tiroides: revisión de la literatura / External laryngeal trauma and thyroid cartilage fracture: a literature review

RESUMEN El trauma laríngeo constituye un grupo de lesiones infrecuentes, pero de gran importancia clínica dada su alta morbimortalidad. Requiere un alto nivel de sospecha, puesto que muchas de estas lesiones pueden pasar desapercibidas en la evaluación inicial. Se debe sospechar en todo paciente que se presenta con traumatismo cervical y síntomas que van desde la disfonía y el dolor cervical anterior, a la disnea e incluso el compromiso respiratorio severo por obstrucción de la vía aérea. El abordaje de estos pacientes debe iniciar con la evaluación de la vía aérea y asegurar su estabilidad, para luego enfocarse en el diagnóstico y manejo específico de las lesiones. Presentamos a continuación una revisión bibliográfica en cuanto a los mecanismos de trauma, presentación clínica, diagnóstico, clasificación y manejo.

ABSTRACT The laryngeal trauma constitutes a group of infrequent lesions, but with great clinical importance, given its high morbidity and mortality. It requires a high level of suspicion, since many of these injuries may go unnoticed at the initial evaluation. It should be suspected in every patient presenting with cervical trauma and symptoms ranging from dysphonia and anterior cervical pain, to dyspnea or even severe respiratory distress, due to obstruction of the airway. The approach of these patients should begin with the evaluation of the airway and ensure its stability, to then focus on the diagnosis and specific management of the lesions. We present an updated literature review regarding the mechanisms of trauma, clinical presentation, diagnosis, classification and management.

Newer trends in hanging death.

A total of 105 cases of deaths due to hanging were studied in a span of 5 years time. This present study throws some light on the emerging trends that Hanging is increasingly being adopted by a relatively younger age group who are mostly illiterate and of poor socio-economic status. Hanging being viewed as giving swift painless death and without much expenses and without arousing much suspicion, this mode is increasingly adopted to commit suicide. Dribbling saliva mark, which was a hallmark of Ante-mortem hanging, is increasingly seen in less number of cases. No incidence of fracture of Hyoid bone being seen in this study, due to the fact that most cases were of lower age group and also may be due to most of the victims adopting soft ligatures and low suspension points. Transverse tears in the Carotid arteries were not seen here and on subjecting to Histo-pathological study, we could detect disruption of intimal layer of Carotid artery. Effect of pressure on layers of skin were seen on Histo-pathological study showing vital reaction changes useful for labelling Ante-mortem hanging.