Direct and indirect injuries of the pharynx and larynx

The neck is characterized by a relatively complex anatomy and a very compact content. It therefore forms an extremely vulnerable part of the human body. Although uncommon, aero-digestive tract injuries caused by trauma present a challenging situation for both the emergency doctor and the head and neck surgeon. Clinical presentations may vary from severe acute distress with immediate life-threatening airway obstruction to apparently more reassuring situations. However, the latter turn out to be frequently misleading, since patients may deteriorate suddenly as the result of unrecognized injuries. In such cases, delayed diagnosis is often associated with increased morbidity and mortality. Due to its role in phonation, breathing and alimentation, injuries to the aero-digestive tract also expose the patient to severe later impairment and a poorer quality of life. Comprehensive airway control remains the highest and often most challenging priority for the emergency physician. Careful clinical examination combined with endoscopy and computed tomography imaging form the key elements in diagnosis and early recognition of patients who may require surgical management.