Fractured Larynx

Fractured Larynx

A fractured larynx occurs when a direct impact causes a break in the voice box. This is a rare but potentially life-threatening injury.

Symptoms of a Fractured Larynx

Fractured larynx symptoms may include pain in the throat, particularly when swallowing. The athlete may have a hoarse voice or even lost their voice. They may be short of breath or coughing up frothy blood. There may be a swelling at the front of the throat where the cartilage has been disrupted.

Causes

The larynx is better known as the voice box. It is found at the front of the neck, at the top of the Trachea (or windpipe).

A fractured larynx occurs after a direct impact to the front of the neck. This is most frequent in road traffic accidents. It can sometimes happen in 'washing line' tackles, where the arm is raised to throat level as the opponents run past.

Laryngeal fractures can be classified into 4 groups:

  • Group 1 includes minor injuries with only mild respiratory symptoms.
  • Group 2 is moderate injuries with a degree of airway compromise and minor mucosal disruption.
  • Groups 3 & 4 are the most serious injuries with severe airway compromise, massive swelling, cartilage exposure, mucosal tears and vocal cord immobility. The difference between groups 3 & 4 is in treatment.
  • Group 4 injuries require a stent.

Treatment

  • If a laryngeal fracture is suspected, seek medical attention as soon as possible.
  • For those with breathing difficulties, call the emergency services immediately.
  • X-rays may be requested to rule out fractures of the cervical vertebrae.
  • A CT scan is usually used to confirm the diagnosis of a 'fractured larynx'.
  • Class 1 injuries are treated with observation, bed rest with the head elevated and humified air. Voice rest and nil-by-mouth may also be advised in the short term.
  • Class 2 injuries are treated with a Tracheostomy to allow breathing if the airways are affected and a direct laryngoscopy (camera inserted down the throat to view the larynx).
  • Class 3 injuries are treated with the above, plus surgical repair.
  • Class 4 injuries are the same as class 3, with the addition of a stent (a tube which keeps the larynx and trachea open)

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