@article {Cefalu222, author = {John N. Cefalu and Danielle C. Williams and Tejas V. Joshi and Alan David Kaye}, title = {Pyriform Sinus Tract Injury After Traumatic Intubation With Resulting Tension Pneumothorax}, volume = {20}, number = {2}, pages = {222--225}, year = {2020}, doi = {10.31486/toj.18.0155}, publisher = {Ochsner Journal}, abstract = {Background: Tension pneumothorax is a serious, potentially life-threatening condition with numerous etiologies. Hypopharyngeal injury, a possible complication of endotracheal intubation, can lead to tension pneumothorax. We describe a hypopharyngeal injury that occurred during endotracheal intubation that resulted in tension pneumothorax.Case Report: A 30-year-old female underwent emergent chest tube placement after sustaining an intraoperative tension pneumothorax caused by pyriform sinus tract injury during traumatic intubation for an elective fistulectomy, debridement of a previous fracture site, and removal and replacement of hardware 4 months from the time of the initial injury. A timely chest x-ray aided in the discovery of the pneumothorax. Postoperatively, the patient{\textquoteright}s tension pneumothorax resolved, her chest tube was removed, and she was extubated during her stay in the trauma intensive care unit. The patient was discharged without any other major complications.Conclusion: Tension pneumothorax is a rare but reported complication that can occur during intubation and intraoperatively. Early recognition of hypopharyngeal perforation is crucial to successful management. Anticipation of a difficult airway can suggest the use of alternative methods of intubation that may reduce the risk of hypopharyngeal perforation.}, issn = {1524-5012}, URL = {https://www.ochsnerjournal.org/content/20/2/222}, eprint = {https://www.ochsnerjournal.org/content/20/2/222.full.pdf}, journal = {Ochsner Journal} }