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Introduction <p>Laryngeal fractures are rare but critical injuries that require prompt evaluation and intervention to prevent long-term complications involving airway compromise, voice disturbance, and dysphagia. These injuries become particularly complex in cases of penetrating neck trauma.</p> Case Presentation <p>A 26-year-old Indian male sustained a comminuted and displaced fracture of the thyroid cartilage and hyoid bone following a bull horn–inflicted penetrating neck injury. The trauma resulted in an anterior commissure defect, extensive soft tissue disruption including torn strap muscles and thyrohyoid membrane, and vascular injury. The patient presented with hemorrhage, respiratory distress in the supine position, hoarseness, and subcutaneous emphysema. Airway stabilization was achieved with an early tracheostomy after confirming cervical spine integrity. Surgical management included open reduction and internal fixation using absorbable sutures, vascular control, and primary repair of torn membranes and musculature. A corrugated drain was placed and removed after 48&#xa0;h. Oral feeding was cautiously initiated at 24&#xa0;h following clinical and endoscopic evaluation. Three months post-surgery, the patient showed near-normal breathing and swallowing, and his voice had improved with speech therapy. CT imaging and video laryngoscopy were instrumental in grading the injury and guiding the surgical approach.</p> Conclusion <p>Early airway stabilization, imaging-based grading of injury, timely surgical repair, and structured rehabilitation are essential for favorable outcomes in penetrating laryngeal trauma.</p>

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Case Report: Comminuted Laryngeal Fracture Following Penetrating Neck Trauma From a Bull Horn—A Surgical Challenge

  • 期刊论文

  • 发表日期：

    2025年7月24日

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  • Gautam Kumar Arora,
  • Pankaj Kumar Doloi,
  • Gunjan Verma

摘要

Introduction

Laryngeal fractures are rare but critical injuries that require prompt evaluation and intervention to prevent long-term complications involving airway compromise, voice disturbance, and dysphagia. These injuries become particularly complex in cases of penetrating neck trauma.

Case Presentation

A 26-year-old Indian male sustained a comminuted and displaced fracture of the thyroid cartilage and hyoid bone following a bull horn–inflicted penetrating neck injury. The trauma resulted in an anterior commissure defect, extensive soft tissue disruption including torn strap muscles and thyrohyoid membrane, and vascular injury. The patient presented with hemorrhage, respiratory distress in the supine position, hoarseness, and subcutaneous emphysema. Airway stabilization was achieved with an early tracheostomy after confirming cervical spine integrity. Surgical management included open reduction and internal fixation using absorbable sutures, vascular control, and primary repair of torn membranes and musculature. A corrugated drain was placed and removed after 48 h. Oral feeding was cautiously initiated at 24 h following clinical and endoscopic evaluation. Three months post-surgery, the patient showed near-normal breathing and swallowing, and his voice had improved with speech therapy. CT imaging and video laryngoscopy were instrumental in grading the injury and guiding the surgical approach.

Conclusion

Early airway stabilization, imaging-based grading of injury, timely surgical repair, and structured rehabilitation are essential for favorable outcomes in penetrating laryngeal trauma.