| Abstract: | Airway trauma can be considered according to the mechanism of injury, which may guide further management. Trauma may be mechanical, either blunt or penetrating, be due to burns or be iatrogenic as a result of instrumentation of the airway. Immediate airway intervention will be required for obvious airway compromise. Such patients may be difficult to manage, and may be complicated by polytrauma. It is important to appreciate the potential for rapid deterioration in patients with an injury to the aerodigestive tract. Delayed diagnosis can result in poor outcomes from airway and neck trauma, and a structured approach to resuscitation, investigations and ongoing care should be adopted. Iatrogenic airway trauma is not confined to patients in whom intubation is difficult or prolonged, although these are risk factors. Pharyngeal and oesophageal perforation are associated with greater risk of mortality than other iatrogenic airway injuries. Cricoarytenoid joint dysfunction, vocal cord palsy, granuloma, haematoma and tracheal stenosis can all occur as a result of airway instrumentation, and may not be apparent until some time later. Specialist referral of these patients is appropriate, and prompt treatment may improve outcomes. Careful sizing of endotracheal tubes and close monitoring of cuff pressures are important in minimizing airway trauma through intubation. |
