Spontaneous longitudinal rupture of the thyroid cartilage: A management of the rare clinical case

Abstract

Introduction and importance: Non-traumatic rupture or other injuries to the larynx are very rare disorder. According to the published series, there are only 15 cases reported with such kind of injury to the larynx. Despite the rarity of the non-traumatic larynx fracture, it is important to elucidate adequate management for the patients with such emergency. The aim of the study is to demonstrate the features of clinical manifestations, examination, and surgical treatment of a case of spontaneous longitudinal rupture of the thyroid cartilage. Presentation of case: A 54-year-old male patient presented with chief complaints of pain in the front surface of the neck, difficulty swallowing and breathing during physical exertion, hyperemia of the skin on the front surface of the neck, and the presence of subcutaneous emphysema. 20 h after the onset of the symptoms, the patient reported breathing difficulties that appeared during physical exertion, and the patient walked to the hospital. Computed tomography revealed a longitudinal rupture of the thyroid cartilage, emphysema of the neck, and the presence of air in the anterior-upper mediastinum. The defect of the ruptured thyroid cartilage was treated by suturing as well as by myoplasty using sternocleidomastoid muscle. Clinical discussion: Our case report is in line with others, showing that patient with spontaneous rupture of the thyroid cartilage is the surgical emergency. Our approach of using myoplasty was not presented before. Conclusion: This case report adds evidence and knowledge about such rare disorders as spontaneous rupture the thyroid cartilage rupture. It is useful to apply the technique of myoplasty with sternocleidomastoid muscle flaps, ensuring reliable sealing of the damaged area reducing the risk of failure, and inflammatory complications, and supporting neck functions in the postoperative period.