Abstract
Airway injuries are life threatening conditions. A very little number of patients suffering air injuries are transferred live at the hospital. The diagnosis requires a high index of suspicion based on the presence of non-specific for these injuries symptoms and signs and a thorough knowledge of the mechanisms of injury. Bronchoscopy and chest computed tomography with MPR and 3D reconstruction of the airway represent the procedures of choice for the definitive diagnosis. Endotracheal intubation under bronchoscopic guidance is the key point to gain airway control and appropriate ventilation. Primary repair with direct suture or resection and an end to end anastomosis is the treatment of choice for patients suffering from tracheobronchial injuries (TBI). The surgical approach to the injured airway depends on its location. Selected patients, mainly with iatrogenic injuries, can be treated conservatively as long as the injury is small (<2 cm), a secure and patent airway and adequate ventilation are achieved, and there are no signs of sepsis. Patients with delayed presentation airway injuries should be referred for surgical treatment. Intraoperative evaluation of the viability of the lung parenchyma beyond the site of stenosis/obstruction is mandatory to avoid unnecessary lung resection.
Highlights
Airway trauma is a life threatening condition which may be a result of blunt and penetrating injuries to the neck and chest, as well as medical procedures that may injure the airway
The aim of this paper is to review the epidemiology, the mechanisms of injury, the diagnosis and the management of the patients suffering from airway injuries
Patients presenting with dyspnoea or recurrent pulmonary infections, a lobar or pulmonary opacification on chest xrays and a history of major trauma should be evaluated via bronchoscopy; once a delayed tracheobronchial injuries (TBI) is diagnosed they should be referred for surgery
Summary
Airway trauma is a life threatening condition which may be a result of blunt and penetrating injuries to the neck and chest, as well as medical procedures that may injure the airway. Conservative management Kiser et al [12] showed that no treatment or conservative management is associated with higher rates of death, several studied have commented on the possibility for non-operative management in patients with postintubation tracheal lacerations [43,66,67,68] The prerequisites for such management include: small lacerations (
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