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The GAA should consider the use of neck guards for hurling and camogie players to prevent serious and life-threatening injuries, doctors have said.

hey highlighted the cases of 21 players who had to be treated for laryngeal injuries – to the area of the neck that contains muscles used for breathing, swallowing and talking.

Three had a thyroid cartilage fracture, while one needed a tracheotomy, where an opening is created in the front of the neck to insert a tube into the windpipe to help a person breathe.

The patient with a tracheotomy was admitted to ICU and had to be fed through a tube up the nose for nine days.

The retrospective study by doctors at the Department of Otolaryngology at Waterford Regional Hospital and the Royal College of Surgeons covered patients treated between 2005 and 2020.

The otolaryngology centre in Waterford serves five counties where hurling and camogie are popular – Waterford, Tipperary, Kilkenny, Carlow and Wexford.

The most common symptoms were hoarseness and pain when swallowing, with all patients describing either or both. Other complaints included coughing blood, surgical emphysema and shortness of breath.

“Laryngeal injuries are uncommon but a potentially fatal condition that poses a risk to the voice and airway of athletes who sustain blunt neck trauma,” the doctors wrote in the Irish Medical Journal.

The mean age of those injured was 20, and half were 16 or younger, including three female players.

Of the 21 injuries, 18 were the result of being hit with a hurley and four with a sliotar, while three were due to a collision with another player.

One concern with such injuries is delayed presentation. Overall, the patients sought help 11 hours after the injury, while one arrived three days later.

Noting injuries are an inevitable part of contact sports, the doctors said laryngeal trauma can be life-threatening due to airway compression and a build-up of fluid.

“Symptoms after blunt trauma to the neck can be subtle and delayed in onset,” they said. “Sports physicians should be attentive to even minor anterior neck trauma and not be distracted by other more obvious injuries.”

Subtle symptoms such as disorders in the voice or painful swallowing should not be ignored. Children have a higher incidence of soft tissue injuries as the laryngeal skeleton is more elastic.

The doctors said life-threatening laryngeal injuries “may be prevented by the introduction of a neck guard that is already employed in sports such as ice hockey”.

“We hope that study will encourage the GAA community to consider the risk of laryngeal injury and introduce a neck guard to safeguard the athletes,” they said.

They pointed out how protective head gear was introduced by the GAA in 2005 and led to a fall in eye injuries.

However, the current protective equipment and nature of the game exposes the neck to significant injury.

They also said physicians should refer players with a suspected laryngeal injury to a specialist early on.

“While eye and head trauma in hurling has received particular emphasis, it is important to increase efforts to protect the larynx,” they said.

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