Strobovideolaryngoscopy in the management of acute laryngeal trauma

Surgical intervention in the management of acute laryngeal trauma can sometimes pose a difficult decision. The objective of this study is to evaluate the effectiveness of strobovideolaryngoscopy (SVL) in determining the course of management for patients sustaining acute laryngeal trauma. A 20-year retrospective study of patients presenting with acute laryngeal trauma was performed in order to determine if the addition of SVL during the study period changed the management of certain acute laryngeal injuries. Patients sustaining blunt laryngeal trauma evaluated at our institution from 1981 to the present were reviewed. There were 40 patients identified that were grouped by severity according to the Schaefer classification. Analysis included mechanism of injury, clinical presentation, assessment, treatment, and outcome. Group 1 injuries were the most common, with motor vehicle accident (MVA) the most frequent mechanism of injury. Initial assessment included fiberoptic laryngoscopy and computed tomography (CT) imaging in all patients not requiring immediate exploration. SVL was used in 20 patients, with 7 undergoing stroboscopy within 24 hours of presentation. All 7 patients were managed conservatively without surgical intervention or the need to establish an alternative airway. SVL improves the clinical assessment of patients with acute laryngeal injury. This study supports its use and found it to be an important factor in determining the need for surgical intervention. SVL may also shorten the hospital stay in these patients.