PENETRATING NECK INJURY EVALUATION AND MANAGEMENT: PENETRATING NECK INJURY

Mukul Yadav; Deepchand; Gaurav Gupta; Vivek Samor; Subhash

doi:10.22159/ajpcr.2023.v16i8.48649

Authors

Mukul Yadav Department of ENT, Sardar Patel Medical College, Bikaner, Rajasthan, India
Deepchand Department of ENT, Sardar Patel Medical College, Bikaner, Rajasthan, India
Gaurav Gupta Department of ENT, Sardar Patel Medical College, Bikaner, Rajasthan, India
Vivek Samor Department of ENT, Sardar Patel Medical College, Bikaner, Rajasthan, India
Subhash Department of ENT, Sardar Patel Medical College, Bikaner, Rajasthan, India

DOI:

https://doi.org/10.22159/ajpcr.2023.v16i8.48649

Keywords:

Penetrating Neck Injury, Evaluation, Management

Abstract

Objective: To study the prevalence of penetrating neck injuries in north-west Rajasthan. Methods: This was a cross-sectional study on 50 patients with penetrating injury to the neck and of either sex fulfilling inclusion and exclusion criteria, who visit our Trauma Centre and ENT OPD at PBM hospital Bikaner during 01 Jan 2022 to 01 Jan 2023. Patients was evaluated and resuscitated as per Advanced Trauma Life Support Protocols. If the patient is stable a multi-detectorcomputed tomography (MDCT) Angiography will be done and treatment was done accordingly. All patients were observed for at least 48 hours prior to discharge. Follow up of all patients was done at 4 weeks and 3 months post discharge. Results: Mean age of study population was 31.53 ± 9.24 yr with age range of 18–70 yr. Maximum 90% caseswere male; 54% cases were urban. 48% cases were in II zone, followed by 24% in III rd zone, 16% in IVth Zone, whereasminimum 12% had injury in multiple zones. conservative treatment was done in 34% cases, 33 cases were treated by surgery out of which 57.57% were treated by surgical debridement and primary wound closure, 88% cases were cured and1(2%) case were died. Conclusion: A proper evaluation, rapid air way intervention and proper surgical repair are essential for a successful outcome. Early management of laryngeal injury within first 24 hours seems to bear the bestresults for air way and voice.

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Author Biographies

Mukul Yadav, Department of ENT, Sardar Patel Medical College, Bikaner, Rajasthan, India

Resident, Department of ENT

Deepchand, Department of ENT, Sardar Patel Medical College, Bikaner, Rajasthan, India

Senior Professor, Department of ENT

Gaurav Gupta, Department of ENT, Sardar Patel Medical College, Bikaner, Rajasthan, India

Professor & HOD, Department of ENT

Vivek Samor, Department of ENT, Sardar Patel Medical College, Bikaner, Rajasthan, India

Professor, Department of ENT

Subhash, Department of ENT, Sardar Patel Medical College, Bikaner, Rajasthan, India

Resident, Department of ENT

References

Burgess CA, Dale OT, Almeyda R, Corbridge RJ. An evidence-based review of the assessment and management of penetrating neck trauma. Clin Otolaryngol 2012;37:44-52. doi: 10.1111/j.1749- 4486.2011.02422.x, PMID 22152036

Mahmoodie M, Sanei B, Moazeni-Bistgani M, Namgar M. Penetrating neck trauma: Review of 192 cases. Arch Trauma Res 2012;1:14-8. doi: 10.5812/atr.5308, PMID 24719835

Ozturk K, Keles B, Cenik Z, Yaman H. Penetrating zone II neck injury by broken windshield. Int Wound J 2006;3:63-6. doi: 10.1111/j.1742- 4801.2006.00177.x, PMID 16650212

Saito N, Hito R, Burke PA, Sakai O. Imaging of penetrating injuries of the head and neck: Current practice at a Level I Trauma Center in The United States. Keio J Med 2014;63:23-33. doi: 10.2302/kjm.2013- 0009-re, PMID 24965876

Sperry JL, Moore EE, Coimbra R, Croce M, Davis JW, Karmy- Jones R, et al. Western Trauma Association critical decisions in trauma: penetrating neck trauma. J Trauma Acute Care Surg 2013;75:936-40. doi: 10.1097/TA.0b013e31829e20e3, PMID 24256663

Rhee P, Kuncir EJ, Johnson L, Brown C, Velmahos G, Martin M, et al. Cervical spine injury is highly dependent on the mechanism of injury following blunt and penetrating assault. J Trauma 2006;61:1166-70. doi: 10.1097/01.ta.0000188163.52226.97, PMID 17099524

Godbole BG, Vira TM, Rao RV. Stab injury of neck (a case report). J Postgrad Med 1980;26:257-8. PMID 7230062

Demetriades D, Theodorou D, Cornwell E, Berne TV, Asensio J, Belzberg H, et al. Evaluation of penetrating injuries of the neck: Prospective study of 223 patients. World J Surg 1997;21:41-7; discussion 47. doi: 10.1007/s002689900191, PMID 8943176

Thoma M, Navsaria PH, Edu S, Nicol AJ. Analysis of 203 patients with penetrating neck injuries. World J Surg 2008;32:2716-23. doi: 10.1007/ s00268-008-9766-7, PMID 18931870

Babu A, Garg H, Sagar S, Gupta A, Kumar S. Penetrating neck injury: Collaterals for another life after ligation of common carotid artery and subclavian artery. Chin J Traumatol 2017;20:56-8. doi: 10.1016/j. cjtee.2015.12.015, PMID 28233726

Madsen AS, Oosthuizen G, Laing GL, Bruce JL, Clarke DL. The role of computed tomography angiography in the detection of aerodigestive tract injury following penetrating neck injury. J Surg Res 2016;205:490- 8. doi: 10.1016/j.jss.2016.06.044, PMID 27664900

Ibraheem K, Khan M, Rhee P, Azim A, O’Keeffe T, Tang A, et al. “No zone” approach in penetrating neck trauma reduces unnecessary computed tomography angiography and negative explorations. J Surg Res 2018;221:113-20. doi: 10.1016/j.jss.2017.08.033, PMID 29229116

PENETRATING NECK INJURY EVALUATION AND MANAGEMENT