Journal of Clinical Images and Medical Case Reports
ISSN 2766-7820
Clinical Image - Open Access, Volume 5
Laryngeal fracture after sneezing
Cilgia Dür1,2; Yves Jaquet1,3#; Roland Giger1*#
1Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
2ENT/ORL, Head and Neck Surgery, Hospital Center Biel, Biel, Switzerland.
3Clinics of Otorhinolaryngology, Head and Neck Surgery, Neuchatel - Pourtalès Hospital, Neuchatel, Switzerland.
#These authors contributed equally to this work and share last authorship.
*Corresponding Author : Roland Giger
Department of Otorhinolaryngology, Head and
Neck Surgery, Inselspital, Bern University Hospital,
University of Bern, Bern, Switzerland.
Email: [email protected]
Received : Aug 20, 2024
Accepted : Sep 10, 2024
Published : Sep 17, 2024
Archived : www.jcimcr.org
Copyright : © Giger R (2024).
Citation: Dür C, Jaquet Y, Giger R. Laryngeal fracture after sneezing. J Clin Images Med Case Rep. 2024; 5(9): 3255.
Description
A healthy 61-year-old man sought emergency care after experiencing neck swelling (Figure 1), throat discomfort, and hoarseness, which developed gradually over two days following a forceful and blocked sneeze. He reported a painful sensation of rupture in his anterior neck. Neck palpation revealed subcutaneous emphysema and clicking sounds over the larynx. Flexible laryngoscopy showed left vocal fold hematoma. CT scan demonstrated a displaced vertical thyroid cartilage fracture (Figure 2), soft tissue emphysema (Figure 2), and pneumomediastinum. Direct laryngoscopy revealed no mucosal defect. An anterior neck approach was performed to repair the midline thyroid cartilage fracture (Figures 3 and 4). The patient rapidly experienced relief from pain. A two-week follow-up showed complete resolution of signs and symptoms. Closed-airway sneezing transmitting high Valsalva pressure is a dangerous manoeuvre and should be avoided, as it may lead to various other intrinsic traumas such as pneumothorax, orbital blow-out fracture, diffuse pneumocephalus, cerebrospinal fluid leak, round window fistula and sensorineural hearing loss, myocardial infarction and aortic dissection.
