Evidence map›Paper›PMID 40481803›Full record

ArticleThe Laryngoscope2025

Penetrating Laryngeal Trauma: Management of Severe Injuries Without Open Reduction Internal Fixation.

Helen Hieu Nguyen, Jane Tong, Andrew Varone, Ryan B Fransman, Deborah M Stein, Elizabeth Guardiani, Grace E Snow

Abstract read
In one paragraph

Article in The Laryngoscope, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Helen Hieu NguyenSchool of Medicine, University of Maryland, Baltimore, Maryland, USA.ORCID 0000-0001-8015-5296
Jane TongDepartment of Otorhinolaryngology-Head and Neck Surgery, University of Maryland School of Medicine, Baltimore, Maryland, USA.
Andrew VaroneR Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland, USA.
Ryan B FransmanR Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland, USA.
Deborah M SteinR Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland, USA.
Elizabeth GuardianiDepartment of Otorhinolaryngology-Head and Neck Surgery, University of Maryland School of Medicine, Baltimore, Maryland, USA.
Grace E SnowDepartment of Otorhinolaryngology-Head and Neck Surgery, University of Maryland School of Medicine, Baltimore, Maryland, USA.ORCID 0000-0001-6246-0035

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThyroid and cricoid cartilage fractures that are displaced or have multiple fracture lines are traditionally managed with open reduction and internal fixation (ORIF). In practice, patients with penetrating laryngeal trauma may have small fragments of cartilage that are difficult to reduce and fixate. This study examines outcomes in patients managed with and without ORIF.

methodsA retrospective review was conducted of patients aged 18 years and older with penetrating laryngeal trauma who were treated at a single Level I trauma center affiliated with a tertiary-level teaching hospital between 2012 and 2022. Demographics, injury characteristics, and fracture management were recorded. The primary outcome was tracheostomy dependence at the last follow-up. Secondary outcomes included time to laryngeal stent removal, time to tracheostomy decannulation, time to feeding tube removal, voice functionality, and hospital length of stay.

resultsThirty-two patients were included. Thirty-one (97%) were men. Mean age was 35 years. The mean injury severity score (ISS) was 19 (range: 5-59). Twenty-six (81%) patients suffered gunshot wound(s), and six (19%) stab wound(s). Twenty-two (69%) patients had Schaefer-Fuhrman group 3 or higher injury. Of 22 (69%) patients requiring tracheostomy, 20 (91%) underwent tracheostomy decannulation and resumed an oral diet. Only five (17%) patients underwent ORIF. All surviving patients had functional voices at the time of the last follow-up, except for two patients unable to voice for neurological reasons.

conclusionPatients with penetrating laryngeal trauma with a Schaefer-Fuhrman Group 3 or higher injury who were managed without ORIF had good recovery from an airway, voice, and swallowing perspective. LEVEL OF EVIDENCE: 4:

Indexed as

Fracture Fixation, InternalLarynxWounds, PenetratingWounds, StabAdultCricoid CartilageFemaleHumansInjury Severity ScoreLength of StayMaleMiddle AgedOpen Fracture ReductionRetrospective StudiesTracheostomyTrauma Centersgunshot woundlaryngeal stentlaryngeal traumaopen reduction internal fixationtracheostomy

Identifiers

PMID40481803
PMCPMC12475532

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.