Endoscopic and ultrasonographic evaluation of external laryngeal injuries in children

Lidia Zawadzka-Głos, Anna Jakubowska, *Magdalena Frąckiewicz, Michał Brzewski

Summary
Aim. The aim of the research is to evaluate the possibilities of diagnosing laryngeal injuries with the use of laryngoscopy and ultrasonographic examination.
Material and methods. There were diagnosed and treated 15 children aged 5-14 (6 girls and 9 boys) with external injuries of the larynx. In all cases laryngoscopy under general anesthesia and radiological examinations including ultrasound of the larynx, X-ray of the cervical spine and in selected cases CT of the chest and neck were performed.
Results. In the studied group of 15 children we observed: hit of neck into a blunt object in 10 children, strangulation with a rope or a scarf in 2 children, transport trauma in 2 children and kick in the neck in 1 child. In ultrasonographic examination the following disorders were revealed: unilateral paralysis of vocal folds (7 children), bilateral paralysis of vocal folds (1 child) and asymmetry of vocal fold movement (1 child). In laryngoscopy immobilization of one vocal fold in 7 children, adhesions in the area of the posterior commissure in 3 children and partial adhesion of vocal folds in one child were confirmed. Incorrect, asymmetrical unilateral adjustment of aryepiglottic folds was observed in ultrasound examination and laryngoscopy in 7 children.
Conclusions. Direct laryngoscopy is a standard in diagnostics of injuries of the larynx. Ultrasonography of the larynx is recommended in every case of laryngeal injury as an additional, non-invasive, complementary diagnostic examination. Ultrasonography in comparison with laryngoscopy under general anesthesia more precisely evaluates mobility of vocal folds and diagnoses fractures of cartilages without dislocation.

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