International Journal of Otorhinolaryngology and Head and Neck Surgery | August 2020 | Vol 6 | Issue 8 Page 1546 International Journal of Otorhinolaryngology and Head and Neck Surgery Shetty S et al. Int J Otorhinolaryngol Head Neck Surg. 2020 Aug;6(8):1546-1548 http://www.ijorl.com pISSN 2454-5929 | eISSN 2454-5937 Case Report Psychosocial effect of COVID-19 lockdown suicidal cut throat injury: a case report Sandeep Shetty, Shilpa Chandrashekar, Nitish Aggarwal*, Kumar Shankar De INTRODUCTION The COVID-19 pandemic and measures required to address it are taking a toll on those with addictive disorders. Various factors such as poverty, physical and mental health vulnerabilities and disruption of services due to restrictions placed on alcohol sales are having major psychological impacts leading to social isolation, increased domestic tensions and serious symptoms of alcohol withdrawal among the dependant population. These include seizures, delirium tremens, hallucinosis and self-harm. 1 Here we describe one such case of delirium tremens with self-inflicted laryngeal trauma. CASE REPORT A 45 years old male, known case of alcohol dependence since, 8 years and history of no consumption for the past 6 days amid COVID-19 lockdown was brought to the emergency department of our hospital with history of self-inflicted neck trauma using a sharp weapon. The patient was unconscious on arrival with a fall in oxygen saturation, pulse rate of 110bpm and blood pressure recording of 110/90 mmHg. Peripheries were warm and bilateral air entry was reduced on chest auscultation. There was a cut laceration in the anterior aspect of neck of 8 cm × 4 cm exposing the laryngeal cartilages. Epiglottis was partially cut causing the floppy segment to obstruct the airway and air leak was also present (Figure 1). Urgent airway management in the form of orotracheal intubation under vision using video-laryngoscopy was done and patient was put on 100% supplementary oxygen support. Pressure dressing to control bleeding was put. Intravenous lines secured and fluids were started. Head end elevation done and patient was prepared for neck exploration and repair. Neck exploration was done under local anaesthesia, large mucosal laceration with exposed thyroid cartilage was noted consistent with Schaefer type III laryngeal injury. No thyroid cartilage fracture was present and anatomy was maintained. Displaced segment of epiglottis blocking the airway was repositioned and sutured to the surrounding soft tissue (Figure 2). No major blood vessels were injured. A Tracheostomy was done at the level of 2 nd to 3 rd tracheal ring. Continuity of laryngeal framework was checked with intra-op direct laryngoscopy using Kleinsasser operating laryngoscope. ABSTRACT The novel coronavirus pandemic of 2020 presents vast challenges to the population particularly to vulnerable ones such as those with addictive disorders amid lockdown with no access to alcohol and difficult to reach overburdened healthcare. We present such a case of a 45 years old alcohol dependent in withdrawal with self-inflicted cut throat injury. Keywords: COVID-19, Delirium tremes, Laryngotracheal trauma Department of Otorhinolaryngology, Head and Neck Surgery, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India Received: 09 May 2020 Revised: 15 June 2020 Accepted: 16 June 2020 *Correspondence: Dr. Nitish Aggarwal, E-mail: nitishaggarwal28@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20203213