Presentation
Hockey ball to the throat, now dysphagia and hoarse voice.
Patient Data
Fracture through the base of the right superior horn of the thyroid cartilage with medial displacement of the superior aspect. Effacement of the right pyriform sinus with asymmetric soft tissue density in this region likely representing hematoma. Slight asymmetry of the vocal cords.
No cricoid cartilage fracture and the arytenoid cartilages have a normal appearance. No hyoid bone fracture. No airway narrowing.
Fat replaced right submandibular gland with right submandibular duct calculus. The remainder of the study is unremarkable.
Fracture through the base of the right superior horn of the thyroid cartilage (red arrow) with medial displacement of the superior aspect (blue arrow).
Case Discussion
Laryngeal trauma is uncommon, and the key to diagnosis, in this case, is the high degree of pre-test suspicion (direct blow, dysphagia, dysphonia) and then careful search, which revealed asymmetry of the vocal cords and pyriform sinus followed by a displaced thyroid cartilage fracture.
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