Thyroid cartilage reconstruction with costochondral graft during primary approach in penetrating cervical trauma - case report

Authors

DOI:

https://doi.org/10.33448/rsd-v11i3.26006

Keywords:

Gunshot wounds; Bronchoscopy; Laryngeal nerve injuries; Neck injuries; Penetrating wounds.

Abstract

Laryngeal trauma is a penetrating injury in the cervical region with great importance in emergency care. Penetrating injuries are associated with ballistic trauma, with a greater chance of endolaryngeal rupture. This case report refers to a male patient who suffered a penetrating injury caused by a firearm in the anterior cervical region with a complex laryngeal lesion, grade IV of Legacy Emanuel. He underwent an emergency cervicotomy with evidence of thyroid cartilage injury, and a cartilaginous graft was performed from the second right costochondral joint, and the patient progressed satisfactorily in the postoperative period without functional speech deficits. It was demonstrated that the application of the technique resulted in the non-rejection of the organ to the graft, with rapid recovery. There was complete epithelialization of the intraluminal face of the graft on the fifth postoperative day evidenced by bronchoscopy and resulting in functional and aesthetic gain for the patient, in addition to a shorter hospital stay. This adopted strategy generated good results without flap rejection, with good aesthetic repercussions and without functional limitations in the patient, reducing the number of surgical approaches, hospitalized time and expenditure of financial resources with hospitalization.

References

Benjamin, B. (2018). Prolonged Intubation Injuries of the Larynx: Endoscopic Diagnosis, Classification, And Treatment. Annals of Otology, Rhinology & Laryngology, 127 (8): 492–507. https://doi.org/10.1177/0003489418790348

Bent J. P, Silver J. R, Porubsky, E. S. (1993). Acute laryngeal trauma: a review of 77 patients. Otolaryngology Head & Neck Surgery, 109 (3): 441–9.

Demetriades, D., Velmahos, G. G., & Asensio, J. A. (2001). Cervical Pharyngoesophageal and Laryngotracheal Injuries. World Journal of Surgery, 25 (8): 1044–1048. https://doi.org/10.1007/s00268-001-0057-9

Elias, N., Thomas, J., Cheng, A. (2021). Management of Laryngeal Trauma. Oral and Maxillofacial Surgery Clinics of North America, 33 (3):417-427. DOI: 10.1016/j.coms.2021.04.007.

Farley, L. S., & Schlicksup, K. E. (2021). Tracheal Injury. In StatPearls. StatPearls Publishing.

Ford, H. R., Gardner, M. J., & Lynch, J. M. (1995). Laryngotracheal disruption from blunt pediatric neck injuries: Impact of early recognition and intervention on outcome. Journal of Pediatric Surgery, 30 (2): 331–335. https://doi.org/10.1016/0022-3468(95)90584-7

Herrera, M., Tintinago, L., Victoria, W., Ordoñez, C. A., Parra, M., Betancourt-Cajiao, M., Caicedo, Y., Guzman, M., Gallego, L., Gonzalez Hadad, A., Pino, L., Serna, J., García, A., Serna, C., & Hernandez, F. (2020). Damage Control of Laryngotracheal Trauma: The Golden Day. Colombia Médica, 51(4): 1-9. https://doi.org/10.25100/cm.v51i4.4599

Jewett, B. S., Shockley, W. W., Rutledge, R. (1999). External laryngeal trauma analysis of 392 patients. Archives of Otolaryngology Head & Neck Surgery Aug. 125 (8), 877-80. DOI: 10.1001/archotol.125.8.877.

Krausz, A. A., Krausz, M. M., & Picetti, E. (2015). Maxillofacial and neck trauma: a damage control approach. World Journal of Emergency Surgery, WJES, 10(31):1-9. https://doi.org/10.1186/s13017-015-0022-9

Ludke, M., & André, M. (1986). Pesquisa em educação: abordagens qualitativas. https://edisciplinas.usp.br/pluginfile.php/4091392/mod_resource/content/1/Lud_And_cap3.pdf

Madsen, A. S., Laing, G. L., Bruce, J. L., Oosthuizen, G. V., & Clarke, D. L. (2016). An audit of penetrating neck injuries in a South African trauma service. Injury, 47 (1): 64–69. https://doi.org/10.1016/j.injury.2015.07.032

Merriam, S. B. (1988). Case study research in education: A qualitative approach. San Francisco: Jossey-Bass, 226p.

Pérez, A. R., Fuentes, E. L. & Tamayo Bavastro, B. (2020). Trauma laríngeo abierto. Reporte de un caso. Multimed, 24 (2): 443-453. http://www.revmultimed.sld.cu/index.php/mtm/article/view/1923

Reid, A., & Ha, J. F. (2019). Inhalational injury and the larynx: A review. Burns, 45 (6), 1266–1274. https://doi.org/10.1016/j.burns.2018.10.025

Sachdeva, K., & Upadhyay, A. (2017). Neck Trauma: ENT Prospects. Indian Journal of Otolaryngology and Head & Neck Surgery, 69 (1): 52–57. https://doi.org/10.1007/s12070-016-1048-3

Schaefer, S. D. (2014). Management of acute blunt and penetrating external laryngeal trauma. Laryngoscope, 124 (1): 233-44. DOI: 10.1002/lary.24068.

Tabarcea, L. (2020). Traumatismo da laringe. Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2020. http://hdl.handle.net/10451/46901

Verschueren, D. S., Bell, R. B., Bagheri, S. C., Dierks, E. J., Potter, B. E. Management of laryngo-tracheal injuries associated with craniomaxillofacial trauma. (2006). Journal of Oral Maxillofacial Surgery, 64 (2): 203–14. DOI: 10.1016/j.joms.2005.10.034.

Welter, S., & Essaleh, W. (2020). Management of tracheobronchial injuries. Journal of Thoracic Disease, 12 (10): 6143–6151. https://doi.org/10.21037/jtd-2019-as-05

Yin, R. K. (2015). Estudo de caso: planejamento e métodos. Porto Alegre: Bookman, 205p.

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Published

19/02/2022

How to Cite

TEODORO, J. A. A. da M.; ALMEIDA, L. R. M. de; FURTADO, W. dos S.; ARAÚJO, F. M. da S.; VELHO, G. C. M. .; BEZERRA, C. T. P. . Thyroid cartilage reconstruction with costochondral graft during primary approach in penetrating cervical trauma - case report. Research, Society and Development, [S. l.], v. 11, n. 3, p. e1311326006, 2022. DOI: 10.33448/rsd-v11i3.26006. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/26006. Acesso em: 13 nov. 2024.

Issue

Vol. 11 No. 3

Section

Health Sciences

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Copyright (c) 2022 João Antônio Ayres da Motta Teodoro; Larissa Radd Magalhães de Almeida; Wendel dos Santos Furtado; Fellipe Marques da Silva Araújo; Giovanna Costa Moura Velho; Caroline Teixeira Pinheiro Bezerra

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