Chirurgie des plaies et traumatismes du larynx et de la trachée cervicale

Blunt and penetrating laryngotracheal injuries can be isolated or integrated into a complex cervical trauma or several traumas. The aim of early surgical treatment is to preserve the functional prognosis and to prevent stenosis. Thyrotomy allows exploration and repair of soft tissues. Restoring normal anatomic relationships is essential. Vocal cords and false vocal cords are resuspended. Thyroid and cricoid cartilage fractures can be managed with wires or miniplates. Partial laryngectomy techniques are sometimes useful in case of cartilage avulsion. Avulsion of the cricoid cartilage is treated either by different reconstructive techniques or by thyro-crico-tracheal anastomosis. Complete laryngotracheal separations are undertaken by crico-tracheal or thyro-crico-tracheal anastomosis. Tracheal traumas without avulsion are treated by sutures or anastomosis. In case of avulsion, tracheal sleeve resection techniques are employed. Tracheal grafts are still experimental. Stents maintain airway patency and permit stabilization of fractures. They should be removed as early as possible.