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  • Trauma Laring

    Diunggah oleh

    Samuel Kadmon Pontoh
    299 tayangan29 halaman
    The document discusses trauma to the larynx. It begins with an introduction on how advances in technology and transportation have led to increased trauma injuries to the head and neck regions. It then covers the etiology, signs and symptoms, classifications, diagnosis and management of laryngeal trauma. Key points include that laryngeal trauma can range from mild injuries to severe life-threatening injuries requiring emergency tracheotomy. Proper classification, endoscopic examination, and stabilization or repair of laryngeal fractures and tissues are important for treatment and prevention of complications.

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    The document discusses trauma to the larynx. It begins with an introduction on how advances in technology and transportation have led to increased trauma injuries to the head and neck regions. It then covers the etiology, signs and symptoms, classifications, diagnosis and management of laryngeal trauma. Key points include that laryngeal trauma can range from mild injuries to severe life-threatening injuries requiring emergency tracheotomy. Proper classification, endoscopic examination, and stabilization or repair of laryngeal fractures and tissues are important for treatment and prevention of complications.

    Hak Cipta:

    Attribution Non-Commercial (BY-NC)
    Unduh sebagai PPT, PDF, TXT atau baca online dari Scribd
    Tandai sebagai konten tidak pantas
    299 tayangan29 halaman

    Trauma Laring

    Diunggah oleh

    Samuel Kadmon Pontoh
    The document discusses trauma to the larynx. It begins with an introduction on how advances in technology and transportation have led to increased trauma injuries to the head and neck regions. It then covers the etiology, signs and symptoms, classifications, diagnosis and management of laryngeal trauma. Key points include that laryngeal trauma can range from mild injuries to severe life-threatening injuries requiring emergency tracheotomy. Proper classification, endoscopic examination, and stabilization or repair of laryngeal fractures and tissues are important for treatment and prevention of complications.

    Hak Cipta:

    Attribution Non-Commercial (BY-NC)
    Unduh sebagai PPT, PDF, TXT atau baca online dari Scribd
    Tandai sebagai konten tidak pantas
    dari 29

    TRAUMA LARING

    PENDAHULUAN
    Perkembangan IPTEK +/+/Kesejahteraan manusia meningkat Bidang Transportasi  Jln Tol >  Kendaraan >  Prevensi < Trauma Tubuh Meningkat  Kepala : Hidung, maksila  Leher : Laring  Torak  Abdomen  Ektremitas

    KLL meningkat

    PENDAHULUAN (Lanjutan)
    Trauma Hidung Gangguan aspek Kosmetik Gangguan Fungsional Obstruksi Jalan nafas

    Trauma Laring & Maksila

    Perlu penanganan cepat dan tepat


    Trauma Maksilofasial Terkait beberapa disiplin ilmu : THT Bedah Mata Saraf Bedah mulut Anestesi

    Team Maksilofasial

    ETIOLOGI TRAUMA LARING I. Trauma mekanik A. Eksterna - kecelakaan mobil (leher kena dashboard) - trauma tumpul / tajam - komplikasi trakeotomi B. Interna - komplikasi tindakan medik (iatrogenik) a.l. : intubasi endotrakea tindakan endoskopi pemasangan pipa nasogastrik

    ETIOLOGI TRAUMA LARING (lanjutan)

    II. Luka bakar a.l. : makanan / minuman terlalu panas hirup udara / gas panas bahan kimia : amoniak, lisol, dsb. III. Trauma akibat radiasi

    Etiologi Trauma Laring o.k. kecelakaan mobil >> akibatkan: Dini : - udim, hematoma, mukosa sobek - emfisema subkutis, mediastinal, pneumotorak - subluksasi / dislokasi sendi krikotiroid, krikoaritenoid - fraktur tulang hioid, tulang rawan tiroid / krikoid

    obstruksi jalan napas Lanjut : - jaringan granulasi stenosis laring - fibrosis obstruksi laring

    KLASIFIKASI TRAUMA LARING Derajat I : kartilago dan perikondrium intak Derajat II : kartilago luka (+) perikondrium

    Derajat III : + lesi pada esofagus, hipofaring

    GEJALA - dispneu stridor obstruksi laringo trakeal (gawat napas) mati trakeotomi cito - disfonia--> afonia disfonia--> - batuk, hemoptisis - hematemesis - nyeri leher - disfagia, odinofagia

    TANDA KLINIS - deformitas leher - emfisema subkutis - nyeri tekan laring - krepitasi

    DIAGNOSIS 1. gejala + tanda klinis 2. pemeriksaan endoskopi : - LD / FOL - esofagoskopi 3. radiologis : - foto leher AP/ lateral torak PA - CT scan

    PENATALAKSANAAN Tujuan : establish on airway Tindakan penyelamat : - Airway (bebaskan jalan napas) - Bleeding (hentikan perdarahan) - Circulation (bila syok --> atasi ! ) -->

    Pastikan

    multi trauma fraktur tulang leher spinal cord injuries ?

    Ingat Triage !

    Urutan Prioritas (Triage)


    Highesest Priority : 1. Cervical spine injury 2. Respiratory impairment 3. Cardiovasc. Insuff. 4. Severe externall haemorrh. haemorrh. High Priority : 1. Intraperitoneal injuries 2. Retroperitoneal injuries 3. Brain & Spinalcord injuries 4. Severe burn & extensive soft tissue injuries Low Priority : 1. Lower genito-urinary tr. Injuries genito2. Pheripheral vasel, nerve & tendon inj. 3. Fracture & dislocations 4. Facial & soft tissue injuries

    TRAUMA LARING RINGAN (Jackson I) - klinis : obstruksi jalan napas (-) / < (- radiologis dan endoskopi (LD / FOL) : udim, hematom ringan mukosa intak (exposed cartilago - ) fraktur single, non displaced - terapi konservatif : 1. istirahat tidur, head up 2. istirahat bicara 3. nebulizer / humidifikasi 4. antibiotika 5. kortikosteroid sistematik Observasi ketat 24 jam pertama !

    TRAUMA LARING SEDANG-BERAT (Jackson II - III) SEDANGTanda obstruksi jalan napas (+)

    Trakeotomi (cito) 3-5 hari Pemeriksaan endoskopi (LD / FOL) Bila : -udim masif -laserasi mukosa luas -tulang rawan exposed -fraktur multipel, displaced -avulsi, dislokasi aritenoid -korda vokalis immobil Eksplorasi Laring

    EKSPLORASI LARING Approach : - Midline thyrotomy - Laryngofissure

    Tujuan : 1. Stabilisasi lumen laring-->reduksi & fiksasi laring-->reduksi 2. Jahit mukosa yang robek 3. Beri penyokong mukosa / kerangka dari dalam --> pasang STENT --> Indikasi : -fraktur tulang rawan multipel, unstable -lesi komisura anterior -laserasi mukosa masif

    Montgomerys Silicone T Tube

    PENCEGAHAN KOMPLIKASI (infeksi, jar.granulasi) 1. Antibiotika (sefalosporin) dan kortikosteroid 2. Lesi mukosa dijahit rapat 3. Handling dan eksisi secara hati-hati hati4. Pasang stent bila ada indikasi 5. Cabut stent : 2 - 4 minggu

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