Laryngeal hematoma

Case contributed by Craig Hacking
Diagnosis certain

Presentation

Hoarse voice post blunt neck trauma one day earlier

Patient Data

Age: 45 years
Gender: Male
ct

There is an undisplaced fracture just to the left of midline within the thyroid cartilage anteriorly lamina (on the bone windows which were not uploaded). The hyoid bone and cricoid cartilage are intact. The thyroid gland is intact.

Above the level of the vocal cords is a rounded area of soft tissue swelling which completely effaces the left pyriform fossa and extends inferiorly through the swollen left aryepiglottic fold. Its superior margin is in the base of the epiglottis, which is not thickened. The vocal cords are slightly thickened. The swelling has mass-effect on the upper airway, with mild narrowing.

The carotid and jugular vessels are normal. No prevertebral edema or soft tissue swelling. The superior mediastinum appears normal. There is loss of normal cervical lordosis. No fracture or acute malalignment demonstrated.

Conclusion:

Undisplaced fracture of the thyroid cartilage and large hematoma in the left pyriform fossa.

Case Discussion

ENT confirmed a hematoma at fiberoptic inspection.

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