Head and Neck Imaging

Trauma, laryngeal

Adequate treatment of laryngeal trauma is necessary to avoid stenosis or aspiration, and to restore an acceptable voice quality. Delay in the treatment may lead to a less good result. Mucosal tears, false passages and tracheal rupture can be identified by laryngoscopy, but extensive soft tissue swelling and injury may limit its diagnostic yield. CT has proven its value in the evaluation of the traumatized larynx, showing fractures of the laryngeal skeleton and their displacement (Fig.1), and outlining soft tissue haematoma and disruption (Fig.2). Surgery can be avoided when CT depicts nondisplaced fractures or normal laryngeal cartilages in the presence of soft tissue haematoma.

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Fig.2

Axial CT image through larynx in a young, dysphonic patient, 6 weeks after a traumatic event; the cartilaginous framework is largely uncalcified. Paramedian depression of the thyroid cartilage (arrow): surgically confirmed fracture. Soft tissue swelling in right paraglottic space (arrowhead) due to haematoma.
Trauma, laryngeal, Fig.1
Trauma, laryngeal, Fig.2