Major airway trauma: a 5-year study in four hospitals in the Middle East

Introduction

Airway trauma is rare but morbid. It is encountered with increasing frequency because of improvements in prehospital care and early initiation of the Advanced Trauma Life Support. This study aims to give a description of patients with airway trauma, to help provide data for better emergency services and delayed managements of this type of trauma.

Methods and materials

This retrospective, cross-sectional study was conducted in four university hospitals in Tehran, Iran; from 1997 to 2002 the study was conducted with 28 patients. Age, sex, mechanism of trauma, site of trauma, clinical manifestations, length of hospitalization, complications, mortality and treatment outcome were the main subjects extracted from the units. SPSS 10.01 was used for analysis.

Results

Twenty-two (78.6%) patients were males and eight (21.4%) patients were female. The mean age was 33.1 ± 2.2 years. Eight (28.5%) cases presented with blunt trauma, 19 (67.8%) with penetrating trauma and one case had inhaled burning chemical agent. Twenty-two (78.6%) of cases had injuries in cervical airways and the remaining six (21.4%) in thoracic airways. Subcutaneous emphysema (50%, seven cases), dysphonia and dyspnea, each with an incidence rate of six (42.8%), were the most frequent manifestations. A total of 85.7% of our patients underwent surgical treatment. The mean length of hospitalization was 5 ± 2 years. The total rate of incidence for complications was 14.2%; two (7.2%) cases of wound infection, one (3.5%) case with anastomosis dehiscence and one (3.5%) case with a collapsed lung after thoracotomy. The mortality rate was 10.7% (three patients). The treatment outcome assessed excellent in 80% of cases, good in one (3.8%) case, acceptable in one (3.8%) case and poor in three (11.5%) cases.

Discussion

Young men were more at risk for airway trauma, especially the penetrating types. A lower mortality and favorable treatment outcome is outstanding in this study. The rate of complication is average. Studies on nonsurgical treatments and autopsy-based studies for airway trauma are suggested for complementary results.