ArticleEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2026
Laryngotracheal blunt and penetrating traumas: proposal of a novel scoring system and management algorithm.
Article in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeLaryngeal and tracheal traumas (LTT) are rare, life-threatening injuries with heterogeneous presentations and outcomes. While the Schaefer-Fuhrman (SF) classification is widely used to categorize them, its narrative nature may limit the applicability in an emergency setting, especially for penetrating injuries. This study aimed to illustrate a structured descriptive proposal for multi-feature scoring system, suitable for the assessment of both blunt and penetrating LTT.
methodsA retrospective review was conducted on 149 patients with LTT presenting between January 2015 and December 2023 at a single tertiary referral hospital. Patients were categorized using both the SF classification and the novel scoring system. The proposed score is based on the presence and severity of 6 features: edema, hematoma, emphysema, mucosal disruption, vocal fold mobility, and fractures, with an additional point for penetrating trauma. A cut-off score of ≥4 was set to indicate the need for prompt surgical management.
resultsThe present cohort consisted of 76.5% blunt and 23.5% penetrating LTT. Based on the SF classification, 6.7% of patients were classified into the surgical groups (Grade III-V), while using the novel scoring system 8.1% of patients scored ≥4. Fisher's exact test confirmed the concordance of the proposed scoring system compared to the SF classification.
conclusionThis novel, multi-feature scoring system proposes a systematic framework for the initial assessment of LTT. It provides a numerical cut-off to complement clinical decision-making, although future prospective, multicentric validation studies are essential to establish its clinical potential.
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