The management of laryngeal fractures using internal fixation.

BACKGROUND: Laryngeal fracture is a rare injury with the potential to affect all functions of the larynx. Restoration of the laryngeal framework is critical for the rehabilitation of laryngeal function.

OBJECTIVE: To ascertain the efficacy of adaptation plate fixation (APF) to repair the laryngeal skeleton.

STUDY DESIGN: Retrospective review of the clinical data of all patients who underwent APF of laryngeal fractures from January 1989 to September 1999.

RESULTS: Our series consisted of 16 men and 4 women presenting with laryngeal fractures caused by blunt (n = 16) or penetrating (n = 4) trauma. Most of these patients presented with severe fractures classified as category III (n = 6), IV (n = 10), or V (n = 1), according to the Schaefer-Fuhrman classification. All patients who required a tracheotomy (n = 13) were de-cannulated. Nineteen of the 20 patients recovered a social voice. The exception was a patient with aphasia secondary to head trauma No patient had aspiration problems. We encountered no complication associated with the use of APF.

CONCLUSION: APF is an effective and well-tolerated method to repair laryngeal fractures.