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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
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

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