External laryngeal trauma.

External laryngeal trauma, blunt or penetrating, is a rare but potentially life-threatening injury. This is frequently seen in multiple-trauma patients and can go unrecognized in the absence of astute clinical awareness. Injuries may range from small endolaryngeal hematomas or lacerations to complete laryngotracheal separation. Proper airway management is of utmost importance and is one of the most controversial aspects of treatment of laryngeal trauma. Flexible fiberoptic laryngoscopy and high resolution computed tomography scanning of the larynx has greatly enhanced the evaluation of these injuries. Treatment options range from conservative, nonsurgical observation to evaluation in the operating room. Surgical intervention may involve endoscopy, open surgical exploration, and possibly laryngeal stenting. Long-term goals are aimed at maintaining voice, airway, and swallowing ability. A systematic approach to this condition often results in predictable and acceptable outcomes.