@article{ref1,
title="Laryngeal fractures in professional and semiprofessional ice hockey players",
journal="Laryngoscope. investigative otolaryngology",
year="2020",
author="Feng, Allen L. and Parikh, Ayush and Gadkaree, Shekhar K. and Naunheim, Matthew R. and Song, Phillip C.",
volume="5",
number="6",
pages="1110-1116",
abstract="OBJECTIVE: Injuries in professional ice hockey players are common, however  significant laryngeal trauma is rare. Here, we present a case series of professional  and semiprofessional ice hockey players to demonstrate the mechanism and nature of  laryngeal injuries they sustain during play, and to recommend best practices for  treatment, prevention, and return to the ice. <br><br>METHODS: A retrospective case review  was done of hockey-related laryngeal injuries between 2016 and 2019 at a tertiary  laryngology practice. Only semiprofessional and professional hockey players were  included. <br><br>RESULTS: In total, four cases were included. All cases involved trauma  from a hockey puck to the neck. No cases were the result of punching, fighting, high  sticks or routine checking. Notably, 1 of 4 presented with severe airway compromise,  requiring urgent intubation, whereas most presented with pain or a significant voice  complaint. Two patients required operative intervention with open reduction and  internal fixation of significantly displaced fractures. One patient experienced  significant mucosal disruption with cartilaginous exposure at the posterior vocal  complex requiring microflap. The average return to ice was 6 weeks for those who  required operative intervention and 4 weeks for those who were managed  conservatively. One patient had persistent mild dysphonia and all others had a  return to baseline phonation. None were wearing neck guards or other protective  equipment at the time of injury. <br><br>CONCLUSION: Though voice and airway injuries are  rarely sustained by ice hockey players, they may require urgent intervention. We  recommend that protective equipment be worn and improved to prevent laryngeal  trauma. LEVEL OF EVIDENCE: 4.<p /> <p>Language: en</p>",
language="en",
issn="2378-8038",
doi="10.1002/lio2.474",
url="http://dx.doi.org/10.1002/lio2.474"
}