Fig. 10

a Axial MDCTA image of a 38-year-old man who sustained a sharp penetrating injury to the midline zone 2 of the neck with a broken bottle (“glassing”). This particular mechanism is typically a combination of sharp penetrating and blunt laryngeal trauma. There is marked endolaryngeal, extralaryngeal and thyroid parenchymal haematoma, particularly on the right. Soft tissue emphysema can be seen outlining the pretracheal fascia which binds the thyroid gland. Further extensive soft tissue emphysema was demonstrated outlining the other deep cervical fascial layers, including the investing layer, the carotid sheath and the prevertebral/alar fascia layer (images not shown). Such extensive soft tissue emphysema should raise significant concern radiologically and clinically for penetration or perforation of the larynx. The patient has been successfully intubated. b Coronal-reformatted MDCTA image of the same patient as in a. Comminuted fracture disruption of the hyoid bone (blue arrows) and comminuted fracture-subluxation of the laryngeal cartilage (black arrow) are evident