• Joshua Yuan Wang Tan, Wan Xin Khoo, Eileen Chor Hoong Hing, Yan Lin Yap, Hanjing Lee, Vigneswaran Nallathamby, Mark Kim Thye Thong, Wei Chen Ong, Jane Lim, and Thiam Chye Lim.
• From the *Yong Loo Lin School of Medicine, †Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore; ‡Division of Plastic, Reconstructive and Aesthetic Surgery, National University Health System; and §Department of Otolaryngology-Head & Neck Surgery, National University Hospital, Singapore.
• Ann Plast Surg. 2016 Feb 1; 77 Suppl 1: S36-8.

AbstractConcomitant maxillofacial, laryngeal and cervical spine injuries may occur after high-energy accidents. Although this presentation is uncommon, the multiple injuries may compromise airway, breathing, circulation, and neurologic function. We identified 8 adult trauma patients admitted to the National University Hospital with the concomitant injuries. We reviewed the patient data and existing literature to identify the important factors that must be considered for management. Seven resulted from high velocity accidents, whereas 1 was assaulted. An algorithm that prioritizes in-tandem diagnosis and acute management of the adult trauma patient with maxillofacial, laryngeal, and cervical spine trauma was developed. The first priority is to assess airway, breathing, and circulation with cervical spine immobilization. Early diagnosis of patients with severe laryngeal injury, confirmation by video endoscopy, and establishing a surgical airway prevents airway obstruction or even a laryngotracheal dissociation. Urgent computed tomography scans of the head and neck are essential for definitive diagnosis and surgical planning for the 3 injuries. Prudent sequencing of surgery is important to avoid complications and to achieve better functional outcomes.

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