Fuhrman Laryngeal Trauma Classification

Group 1Minor endolaryngeal hematomas or lacerations without detectable fracturesFlexible laryngoscopy recommended.Typically managed medically, e.g., steroids, antibiotics, humidification, voice rest, etc.
Group 2More severe edema, hematoma, minor mucosal disruption without exposed cartilage, or nondisplaced fractures.Direct laryngoscopy and esophagoscopySerial examinations, may require tracheotomy +/- medical adjuncts
Group 3Massive edema, large mucosal lacerations, exposed cartilage, displaced fractures, or vocal cord immobility.Direct laryngoscopy and esophagoscopy in ORTracheotomy often required, exploration and surgical repair generally required
Group 4Same as group 3, but more severe, with disruption of anterior larynx, unstable fractures, two or more fracture lines, or severe mucosal injuries.Direct laryngoscopy and esophagoscopyTracheotomy required, stent placement to maintain larynx integrity
Group 5*Complete laryngotracheal separation.Urgent airway evaluation and managementTracheotomy may be difficult due to altered anatomy, complex laryngotracheal repair via low cervical incision

Schaefer SD. The acute management of external laryngeal trauma. A 27-year experience. Archives of Otolaryngology–Head & Neck Surgery. 1192;118(2):598-604.

Fuhrman GM, Stieg FH, Buerk CA. Blunt laryngeal trauma: classification and management protocol. J Trauma. 1990;30(1):87-92.

Similar to Schaefer laryngeal trauma classifcation with addition of Group 5 in Fuhrman laryngeal trauma classification*

Summary Contributed by Emily Zhang