Abstract

In a patient with blunt trauma to the neck, there is potential for airway obstruction. In this situation, clinicians must be alert to protect the airway, and rapid assessment and management are essential for saving the life of the patient. A 56-year-old man with neurofibromatosis suffered from a huge, traumatic cervical hematoma following a fall injury. About 43 hours after the injury, he complained of dyspnea, and respiratory failure developed due to the cervical hematoma enlarging. After an emergency cricothyroidotomy, his ventilation was improved. Neck exploration was done, and the culprit vessel - the external carotid artery - was ligated. A high index of suspicion and a serial evaluation for delayed airway complications in neck trauma patients with neurofibromatosis are required because their blood vessels can be genetically fragile to minor trauma. Therefore, ED physicians should know about the management of difficult airways and should not hesitate performing an emergency cricothyroidotomy as a definitive rescue technique for the failed airway.

• Keywords: Airway obstruction, Cervical hematoma, Neurofibromatosis, Difficult airway, Cricothyroidotomy