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February 13, 2018

Bike Helmets Can Potentially Fracture the Voicebox

Image courtesy of vectorolie
at FreeDigitalPhotos.net
Bike and motorcycle helmets are known to help protect against head injury. However, it may come at the cost of injuring the voicebox due to the clasp used to secure the helmet during a crash.

In a research paper published in Jan 2018, 3 documented laryngeal fractures in a single medical institution were described. It is unknown whether additional laryngeal fractures have occurred due to helmet use that was never reported or identified.

Theoretically, such voicebox injuries from helmet use can extend to even sports that require helmet use such as ice hockey and football. After all, a fracture to the hyoid or larynx is not uncommon in martial arts during hand/foot strikes as well as chokeholds.

If you think about it, if the helmet clasp is kept loose such that it drapes lower under the jaw, during a crash with helmet movement, the clasp can suddenly strike the hyoid and laryngeal bones like a garrote resulting in injury if not fracture.

With injury or fracture to the voicebox, a person can experience throat pain, trouble swallowing, and hoarseness at a minimum and in the worst case scenario, airway swelling causing potential breathing compromise.

With PROPER helmet use, the chinstrap should be cinched tight enough such that it is snugly up against the chin and mandible. In other words, the chinstrap should not be kept loose; a step that appears to be universally violated by many individuals who wear helmets.

However, even with proper helmet use, if the helmet impact is hard enough, the strap can slip and strike the voicebox and as such, alternative helmet design may need to be implemented to minimize this type of injury, in particular the clasp positioning away from the midline.

Reference:
Helmet Clasp Cracks Larynx? A Case Series and Literature Review. Ann Otol Rhinol Laryngol. 2018 Jan 1:3489418755405. doi: 10.1177/0003489418755405. [Epub ahead of print]
Fauquier blog
Fauquier ENT

Dr. Christopher Chang is a private practice otolaryngology, head & neck surgeon specializing in the treatment of problems related to the ear, nose, and throat. Located in Warrenton, VA about 45 minutes west of Washington DC, he also provides inhalant allergy testing/treatment, hearing tests, and dispenses hearing aids. He is also the chief medical officer of O2Labz, a medical and scientific 3D animation company.Google+ Christopher Chang, MD Bio

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