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Laryngeal injury in a coronavirus disease 2019 caregiver following voluntary cough-holding within an inappropriately sized personal protective equipment suit

Part of: JLO Coronavirus Collection

Published online by Cambridge University Press:  28 April 2022

M Dutta Open the ORCID record for M Dutta [Opens in a new window]  and
G Raghu
M Dutta*
Affiliation:
Department of Otorhinolaryngology and Head–Neck Surgery, Medical College and Hospital, Kolkata, India
G Raghu
Affiliation:
Department of Otorhinolaryngology and Head–Neck Surgery, Medical College and Hospital, Kolkata, India
*
Author for correspondence: Dr Mainak Dutta, Department of Otorhinolaryngology and Head–Neck Surgery, Medical College and Hospital, 88 College Street, Kolkata – 700073, West Bengal, India E-mail: duttamainak@yahoo.com
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Abstract

Objective

To document laryngeal framework rupture following voluntary cough-holding as an airway complication of donning a personal protective equipment suit that was too small in size.

Methods

Clinical record and literature review, with proposition of plausible aerodynamics of the airway injury.

Results

Whilst carrying out his duty in the coronavirus disease ward, a resident attempted to stifle a paroxysm of cough when wearing a personal protective equipment suit that was too small with his neck flexed and restricted. There was a sudden release of pressure, intense pain and swelling in the neck with crepitus. Imaging revealed a non-displaced fracture in the lower end of the partially ossified right thyroid lamina, a cricothyroid membrane tear and subcutaneous emphysema. The symptoms resolved gradually on conservative management.

Conclusion

This report underlines the importance of donning appropriately sized personal protective equipment and encouraging its proper use amongst coronavirus disease 2019 caregivers. Non-traumatic laryngeal injury, itself a rare event, has never been reported as a posture-related complication of wearing personal protective equipment.

Keywords

COVID-19PandemicsPersonal Protective EquipmentLarynx

Information

Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 137 , Issue 3 , March 2023 , pp. 342 - 349
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Dr M Dutta takes responsibility for the integrity of the content of the paper

References

Vindrola-Padros, C, Andrews, L, Dowrick, A, Djellouli, N, Fillmore, H, Gonzalez, EB et al. Perceptions and experiences of healthcare workers during the COVID-19 pandemic in the UK. BMJ Open 2020;10:e040503CrossRefGoogle ScholarPubMed
Dutta, M, Azgaonkar, SP. Residents and the COVID-19 caregiver duty. Ear Nose Throat J 2021. Epub 2021 Nov 26CrossRefGoogle ScholarPubMed
World Health Organization. WHO Coronavirus (COVID-19) Dashboard. In: https://covid19.who.int/ [19 November 2021]Google Scholar
Brooks, SM. Perspective on the human cough reflex. Cough 2011;7:10CrossRefGoogle ScholarPubMed
Sbeih, F, Tierney, WS, Bryson, PC, Kominsky, AH. Considerations and management of a laryngeal fracture after sneezing. Am J Otolaryngol 2021;42:103036CrossRefGoogle ScholarPubMed
Tsur, N, Amitai, N, Shoffel-Havakuk, H, Abuhasira, S, Hamzany, Y. Forceful sneeze: an uncommon cause of laryngeal fracture. Radiol Case Rep 2021;16:742–3CrossRefGoogle ScholarPubMed
Byrne, B, Tillman, R, Johansson, M. Laryngeal fracture after a stifled sneeze: a case report. J Emerg Med 2020;58:e97–8CrossRefGoogle ScholarPubMed
Ateş, MS, Turhal, G, Aysel, A, Durusoy, D, Öztürk, K. A case with thyroid cartilage fracture after sneezing. Turk Arch Otorhinolaryngol 2020;58:197–9CrossRefGoogle ScholarPubMed
Matrka, L, Li, M. Laryngeal fracture following violent sneeze: management and biomechanical analysis. OTO Open 2018;2:2473974X18757741CrossRefGoogle ScholarPubMed
Santamaría, A, Alarcón, R, Sepúlveda, I, Fredes, F. Nontraumatic laryngeal fractures: report of two cases and review of the literature. Case Rep Otolaryngol 2017;2017:2153521Google ScholarPubMed
Reuther, MS, Weissbrod, PA. Voice change, odynophagia, and neck pain following a sneeze. JAMA Otolaryngol Head Neck Surg 2017;143:89–90CrossRefGoogle ScholarPubMed
Fenig, M, Strasberg, S, Cohen, JC, Almadi, R, Gold, M. Laryngeal fracture after coughing. Am J Emerg Med 2013;31:1421.e1–3CrossRefGoogle ScholarPubMed
Alexander, VRC, Toynton, S. Spontaneous fracture of the larynx after coughing. Otolaryngol Head Neck Surg 2012;147:801–2CrossRefGoogle ScholarPubMed
Faden, DL, Elackatuu, A, Platt, M. The “closed-airway sneeze”: an unusual cause of laryngeal fracture. Otolaryngol Head Neck Surg 2011;145:515–16CrossRefGoogle ScholarPubMed
Martínez, AB, Juara, AM, Moya, JJL. Fracture of thyroid cartilage after a sneezing episode [in Spanish]. Acta Otorrinolaringol Esp 2007;58:73–4Google Scholar
Quinlan, PT. Fracture of thyroid cartilage during a sneezing attack. Br Med J 1950;1:1052CrossRefGoogle ScholarPubMed