An Algorithm for the Management of Concomitant Maxillofacial, Laryngeal, and Cervical Spine Trauma

作者：Tan Joshua Yuan Wang; Khoo Wan Xin; Hing Eileen Chor Hoong; Yap Yan Lin; Lee Hanjing; Nallathamby Vigneswaran; Thong Mark Kim Thye; Ong Wei Chen; Lim Jane; Lim Thiam Chye^*

来源：Annals of Plastic Surgery, 2016, 77: S36-S38.

DOI：10.1097/SAP.0000000000000710

• craniomaxillofacial
• laryngeal
• cervical
• spinal
• trauma
• fracture
• concomitant algorithm

Concomitant maxillofacial, laryngeal and cervical spine injuries may occur after high-energy accidents. Although this presentation is uncommon, the multiple injuries may compromise airway, breathing, circulation, and neurologic function. We identified 8 adult trauma patients admitted to the National University Hospital with the concomitant injuries. We reviewed the patient data and existing literature to identify the important factors that must be considered for management. Seven resulted from high velocity accidents, whereas 1 was assaulted. An algorithm that prioritizes in-tandem diagnosis and acute management of the adult trauma patient with maxillofacial, laryngeal, and cervical spine trauma was developed. The first priority is to assess airway, breathing, and circulation with cervical spine immobilization. Early diagnosis of patients with severe laryngeal injury, confirmation by video endoscopy, and establishing a surgical airway prevents airway obstruction or even a laryngotracheal dissociation. Urgent computed tomography scans of the head and neck are essential for definitive diagnosis and surgical planning for the 3 injuries. Prudent sequencing of surgery is important to avoid complications and to achieve better functional outcomes.

• 出版日期2016-8