Perioperative Anaesthetic Management of Penetrating Anterior Neck Injuries With Laryngotracheal Disruption: A Case Series

Penetrating anterior neck injuries with laryngotracheal disruption create an immediate airway challenge because instrumentation may worsen tissue disruption or air leakage.We describe the perioperative anaesthetic management of three patients requiring emergency airway control, exploration and definitive repair.The injuries differed in mechanism, anatomical extent, associated cervical injury and physiological status.In the first patient, video laryngoscopy with manual in-line stabilisation was planned because of an associated C3 vertebral fracture; in the other two, direct laryngoscopy allowed careful advancement of a smaller tracheal tube beyond the injured segment.Definitive tracheostomy and repair were subsequently performed in all three patients.Two patients required postoperative mechanical ventilation for approximately 12 and 18 hours, respectively.All three patients had satisfactory airway and functional outcomes.These cases emphasise anatomy-driven airway planning, controlled distal airway access, immediate readiness for surgical airway rescue and close coordination between anaesthesia and otolaryngologist (ENT) teams.