Airway/Head and Neck
Introduction
Equestrian-related trauma poses a significant risk to paediatric and adolescent riders, with head and neck injuries contributing disproportionately to severe morbidity and mortality. Within ENT practice, airway involvement represents a high-risk subset of these injuries. Although uncommon, tracheal trauma is associated with rapid clinical deterioration and requires early recognition and urgent management.
Coblation is a minimally invasive technique widely used in ENT to ablate soft tissues at low temperatures through the use of radiofrequency energy and saline. Indications for its use continue to grow, with its use widely accepted for management of tracheal pathology such as granulation tissue.
Method & Results
We report the case of a 14-year-old female who sustained blunt neck trauma following a horse kick. A CT scan demonstrated disruption of the anterior proximal tracheal wall with associated subcutaneous emphysema, consistent with blunt proximal tracheal injury. Coblation was successfully utilised to manage the disrupted tracheal rings endoscopically, and the patient recovered without complication.
Conclusion
This case highlights the potential role of coblation as a novel therapeutic option in the management of tracheal ring disruption, and adds another indication for which the technology can be successfully utilised.
References
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3 Weber CD, Nguyen AR, Lefering R, Hofman M, Hildebrand F, Pape HC. Blunt injuries related to equestrian sports: results from an international prospective trauma database analysis. Int Orthop. 2017 Oct;41(10):2105-2112. doi: 10.1007/s00264-017-3592-1. Epub 2017 Aug 11. PMID: 28801837.