A complete transection of larynx

Acute laryngeal injury is a rare, potentially lethal injury. It often poses difficulty in airway management. Commonly described are external laryngeal or blunt injuries. We report a case of penetrating neck injury resulting in complete transection of cricoid cartilage. A lady presented with a large, deep slash wound in her neck from a knife injury. There was complete laryngotracheal separation. The airway was secured before she was taken to the operating theatre. A tracheostomy was performed. Exploration revealed the cricoid ring was cut horizontally into two. Anastomosis of the cartilaginous framework was undertaken. Fibreoptic laryngoscopy showed bilateral vocal cords paralysis. After two months the patient recovered without airway compromise, she regains her voice. Repeat laryngoscopy showed good mobility of the vocal cords. In conclusion surgical reconstruction should be meticulously done to ensure good respiratory and phonatory abilities.