Which structure is most likely injured in a clothesline neck injury with painful swallowing and hoarseness?

Which structure is most likely injured in a clothesline neck injury with painful swallowing and hoarseness?

• A. Larynx
• B. Trachea
• C. Esophagus
• D. Thyroid gland

Answer: (A)

Hoarseness points to injury of the larynx because the vocal cords reside there and control voice quality. When the larynx is traumatically struck, edema, hematoma, or damage to the vocal cords can make the voice hoarse. Painful swallowing can accompany this due to mucosal injury and swelling in the laryngeal area. Other structures would present differently: injury to the trachea would more likely cause airway symptoms such as coughing, wheeze, or trouble breathing; injury to the esophagus typically causes odynophagia and dysphagia without voice changes; injury to the thyroid gland might cause neck swelling or hormonal symptoms, and would not explain hoarseness unless the nerve to the vocal cords is affected. In the setting of a blunt neck injury with hoarseness and painful swallowing, the larynx is the most likely structure involved.

Hoarseness points to injury of the larynx because the vocal cords reside there and control voice quality. When the larynx is traumatically struck, edema, hematoma, or damage to the vocal cords can make the voice hoarse. Painful swallowing can accompany this due to mucosal injury and swelling in the laryngeal area. Other structures would present differently: injury to the trachea would more likely cause airway symptoms such as coughing, wheeze, or trouble breathing; injury to the esophagus typically causes odynophagia and dysphagia without voice changes; injury to the thyroid gland might cause neck swelling or hormonal symptoms, and would not explain hoarseness unless the nerve to the vocal cords is affected. In the setting of a blunt neck injury with hoarseness and painful swallowing, the larynx is the most likely structure involved.