REPAIR OF LARYNGEAL FRACTURES USING ADAPTATION PLATES

Background. There is a need to evaluate the effectiveness of laryngeal fracture repair using rigid adaptation plates. Methods. A retrospecti ve chart review of patients undergoing open repair of laryngeal fractu res using metal alloy plates, from 1987 to 1995, was performed. Postop erative airway, deglutition and voice were assessed. Postoperative fol low-up ranged from 1 to 58 months (median, 27 months). All 10 patients sustained blunt or penetrating laryngeal trauma. After patients were resuscitated according to the ABC principles recommended by the Americ an College of Surgeons, each underwent open repair of laryngeal fractu res using rigid adaptation plates.Results. Outcome was measured by per ceptual analysis of the postoperative airway, swallowing, and voice, a s well as biocompatibility. Ten patients underwent repair and stabiliz ation of the larynx using adaptation plates. Nine patients sustained b lunt trauma, and one patient sustained penetrating trauma. Voice was s ubjectively graded as good if it resembled the preinjury status, fair if it differed, and poor ii it represented aphonia, whisper; or uninte lligible speech. Airway was graded as good ii it resembled preinjury s tatus, fair ii mild exercise intolerance or aspiration existed, and po or ii the patient could not be decannulated. Nine patients had a good airway following repair, and six of seven patients requiring tracheoto my were decannulated. All patients tolerated the plates well and suffe red no surgical complications. Conclusion. Repair of the laryngeal fra mework using adaptation plates provides adequate, immediate stabilizat ion with restoration of function and is an alternative to traditional methods of repair. (C) 1998 John Wiley & Sons, Inc.