In contrast to internal trauma to the larynx caused by endolaryngeal procedures, trauma to the larynx caused by external
forces is relatively rare. Nevertheless, the great variety of these external traumata warrants a thorough diagnosis and understanding
of each case as well as a standardized and accepted method for classifying these injuries. These preconditions will facilitate
successful therapy. At our three institutions cases of external trauma to the larynx, including the mechanisms of trauma,
were reviewed and analyzed. Cases were classified according to the mechanisms and the sequelae of trauma. The three major
categories were (a) external trauma due to the impact of blunt objects, (b) trauma after tearing of the neck and the larynx
longitudinally, and (c) external trauma caused by sharp objects and gunshots. In the great majority of cases external trauma
to the larynx was caused by blunt pressure and was most often due to strangulation in the course of (attempted) suicide or
homicide. In a smaller number of cases sharp instruments caused external traumata. In patients surviving the immediate trauma
a meticulous laryngological assessment is necessary. In addition to indirect laryngoscopy, we consider microlaryngoscopy as
being indicated for investigating the soft tissues of the endolarynx. The status of the laryngeal skeleton can be determined
more precisely via high-resolution computed tomography and ultrasound. Early diagnosis and appropriate therapy have a significant
impact on the patient’s condition later, especially as regards scar formation, ease of breathing, and voice quality.
Key words Trauma - Larynx - Fracture - Rupture - Classification
Received: 16 August 1999 / Accepted: 19 May 2000