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Case Report/Case Series |

Laryngeal Fractures in Lacrosse Due to High Speed Ball Impact

Christopher French, MD1; Richard Kelley, MD1
[+] Author Affiliations
1Department of Otolaryngology, State University of New York (SUNY) Upstate Medical Center, Syracuse, New York
JAMA Otolaryngol Head Neck Surg. 2013;139(7):735-738. doi:10.1001/jamaoto.2013.3565.
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Importance  Men’s lacrosse is a fast-paced, high-collision sport with ball speeds in excess of 90 mph. Laryngeal fractures in lacrosse are a rarely reported injury. To increase awareness of this potential injury, we describe 3 male lacrosse players who sustained laryngeal fractures from lacrosse ball trauma to the neck.

Observations  The first patient sustained a minimally displaced, paramedian thyroid cartilage fracture and was managed with observation alone. The second patient sustained a depressed fracture of the left thyroid ala and was managed with closed reduction. The third case sustained a mildly displaced transcricoid fracture. He was managed with open reduction and internal fixation. All 3 patients returned to regular activities with near normal voice results by final follow-up.

Conclusions and Relevance  This is the first report of laryngeal fractures following lacrosse ball trauma to the neck. Lacrosse players are at risk for laryngeal injuries, and neck protection is only worn by the goalie. It is our hope that this series will raise awareness of this potentially lethal injury and prompt the sport to consider mandatory neck protection for all players.

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Figure 1.
Case 1: Computed Tomographic Scan

Computed tomographic scan of the neck reveals a left-sided, minimally displaced, paramedian thyroid cartilage fracture.

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Figure 2.
Case 2: Computed Tomographic Scan and Intraoperative Photograph

A, Computed tomographic scan of the neck revealing a depressed fracture of the left thyroid ala. B, Intraoperative photograph during microdirect laryngoscopy demonstrating a posterior laceration of the left true vocal fold with an avulsed vocal process.

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Figure 3.
Case 3: Computed Tomographic Scan

Computed tomographic scan of the neck revealing a mildly displaced transcricoid fracture.

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Laryngeal fractures in lacrosse due to high speed ball impact. JAMA Otolaryngol Head Neck Surg 2013;139(7):735-8.
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