Epidemiological and Laryngoscopic Characteristics of Head and Neck Burns Requiring Airway Evaluation: A Single-Center Retrospective Cohort

Background and Objectives: Head and neck burns are a clinically demanding subset of burn injury because of their potential for life-threatening airway compromise, cosmetic disfigurement, and psychological morbidity. Although systematic flexible fiberoptic laryngoscopy has been advocated for airway triage in this population, real-world epidemiological and laryngoscopic data from mixed pediatric and adult cohorts, particularly outside high-income Western settings, remain limited. This study aimed to describe the epidemiological characteristics, anatomical distribution, laryngoscopic findings, and airway management outcomes of patients with head and neck burns who underwent flexible fiberoptic laryngoscopy for a clinical indication of suspected airway involvement at a Turkish tertiary burn center. Because inclusion required a laryngoscopy indication, patients with low-risk, isolated facial burns without airway concern were not represented in this cohort, and the reported proportions should not be interpreted as population-level prevalence estimates. Materials and Methods: This retrospective, single-center observational study analyzed 279 patients with head and neck burns who underwent flexible fiberoptic laryngoscopy at a tertiary burn center between June 2022 and December 2024. Burn etiology was undocumented in 117 patients (41.9%); inferential comparison of etiology between age groups was therefore restricted to the 162 patients with documented etiology, using the chi-square test. Total body surface area (TBSA) and burn depth were not systematically recorded in the electronic health record during the study period and could not be analyzed. Results: Mean age was 25.4 ± 22.6 years (43.4% pediatric, 56.6% adult). Among the 162 patients (58.1%) with documented etiology, scalding predominated in children (57.4%), whereas flame (31.9%) and explosion injuries (23.4%) were more common in adults (χ2 = 68.23, df = 4, p < 0.001); as etiology was undocumented in the remaining 41.9% of the cohort, this comparison should be interpreted with caution. The face (70.3%) and upper airway (42.3%) were the most frequently involved regions. Laryngoscopy showed mucosal edema in 41.2% and hyperemia in 19.4% of patients. Endotracheal intubation was required in 4.7% and tracheostomy in 1.8% of patients; no mortality attributable to head and neck burns was observed. Conclusions: Because etiology was undocumented in 41.9% of the cohort, the observed age-related differences in documented burn etiology should be regarded as hypothesis-generating rather than definitive, despite reaching statistical significance. Similarly, because standardized burn-severity metrics were unavailable, the low airway-intervention rate cannot be causally attributed to the laryngoscopic protocol and more plausibly reflects the heterogeneous, predominantly mild-to-moderate severity spectrum of the cohort. These findings are best regarded as descriptive and hypothesis-generating, underscoring the need for prospective, multicenter studies with standardized severity documentation to support evidence-based airway management protocols in head and neck burn patients.