Tracheal Trauma

Excerpt

The trachea is a cartilaginous tube that courses through the neck and upper chest to connect the pharynx and larynx to the lungs. The trachea bifurcates at the carina into the right and left primary bronchi, via which inspired air is delivered to lung tissue, and expired out. The study of tracheal injury is often combined with adjacent airway structures (tracheobronchial trauma, laryngotracheal trauma). See image below.

Trauma to the trachea may be penetrating or blunt and acute or subacute. A blow or stab wound to the neck, or crush injuries to the upper chest, may cause acute traumatic disruption of the trachea, but subacute insults also occur (e.g., from an overinflated endotracheal tube [ETT] cuff pressing against the internal tissues of the trachea over time). Blunt trauma to the neck may result in shearing of the trachea, usually within 3 cm of the carina. Depending on the mechanism, tracheal trauma may be associated with trauma to nearby structures including bony disruptions of the cervical spine, vascular injury to the great vessels, carotids, or jugulars, or digestive tract involvement. Regardless of the mechanism, early diagnosis and surgical repair are crucial to reducing complications and loss of respiratory function.