Laryngeal Trauma: Common Findings and Imaging Pearls

Laryngeal trauma is a rare injury, occurring in less than 1% of all trauma settings, but it is associated with high morbidity and mortality if not properly detected and treated. Laryngeal injuries may be obscured clinically by superimposed maxillofacial injuries. Relatively subtle radiographic findings contribute to delayed or missed diagnosis of laryngeal injury. Cervical spine CT, frequently performed in trauma victims, includes the larynx; however, laryngeal injuries can be overlooked if the neuroradiologist is not aware of varying radiographic appearances. Multideterctor CT findings of the normal larynx and laryngeal injuries, including hyoid fracture, cartilage fracture, mucosal tear, submucosal hematoma, and cricoarytenoid dislocation, are presented. Normal variants and disease-mimicking trauma are also discussed. The clinical signs, symptoms, and classification of laryngeal injuries are reviewed with a focus on the management of these critically ill patients. The radiologist can play a significant role in the management of these patients because accurate interpretation of CT findings can affect airway management in the acute setting and can be used as a roadmap for planning surgical repair. Knowledge of normal anatomy and the radiographic appearance of laryngeal injury facilitates accurate imaging interpretation in these critically important patients.

Learning Objective: Describe the imaging appearance of laryngeal injuries and list the critical radiographic findings that affect clinical management.