BRIAN S. JEWETT, MD; WILLIAM W. SHOCKLEY, MD; ROBERT RUTLEDGE, MD

CHAPEL HILL, NORTH CAROLINA

External laryngeal trauma (ELT) is a rare but clinically important injury. The purpose of this study was to perform the first population-based, time series analysis of the epidemiology, management, and outcome of ELT using an 11-state trauma database containing over 6 million patients. All patients with the diagnosis of ELT were analyzed, and the incidence over a 5-year period was determined to be 0.007%. Three hundred ninety-two patients, with an average age of 37 years and an overall mortality of 2.04%, were identified. Two hundred fifty-four patients had a primary diagnosis of ELT, with a mortality of 0.79%. The average length of stay for 67 patients not requiring operative intervention for any injury was 3 days, with no mortality. One hundred seventy-six patients underwent endoscopy, with 14 requiring tracheotomy alone and 57 requiring tracheotomy plus laryngeal repair. The average length of stay and mortality were higher in these latter groups. Overall, 134 patients underwent tracheotomy, with a mortality of 5%, while 96 patients underwent laryngeal repair, with a mortality of 1%. One hundred forty patients received immediate surgical treatment, while another 60 received treatment within 24 hours. Associated injuries included skull base or intracranial injury (13%), open neck injury (9%), cervical spine injury (8%), and esophageal or pharyngeal injury (3%). Additional epidemiological, financial, and frequency information will also be discussed. We conclude that ELI is a rare injury, with most patients requiring operative intervention.