Emergent reconstruction of laryngeal penetrating neck injury: A case report

ABSTRACT

@#<p><strong>OBJECTIVE:</strong> This paper aims to describe an unconventional surgical procedure performed in a case of penetrating neck injury involving the larynx.</p><p><strong>METHODS:</strong></p><p><strong>Design:</strong> Case Report</p><p><strong>Setting:</strong> Tertiary Government Hospital</p><p><strong>Population</strong>          One</p><p><strong>RESULTS:</strong> A 38-year-old man sustained a hacking laceration to the anterior neck that extended into the hypopharyngeal area, transecting the thyroid cartilage. After pre-emptive tracheostomy, the patient was referred to otorhinolaryngology - head and neck surgery due to the extensive hypopharyngeal injury. Neck exploration performed to control bleeders confirmed a Schaefer-Fuhrman Classification Group 3 penetrating neck injury. Anastomotic reconstruction of the hypopharynx, transected thyroid cartilage and strap muscles was attempted using absorbable sutures with post-operative re-establishment of structural continuity and documentation of full bilateral vocal fold mobility. The patient was about to be discharged home with a tracheotomy and nasogastric tube when he suddenly deteriorated and expired on the eighth post-operative day.</p><p><strong>CONCLUSION:</strong>  Our technique might be utilized in cases where urgent reconstruction of laryngeal structures is considered despite serious damage to the laryngeal skeleton, and may provide a temporary surgical option for similar cases in an emergent setting. However, we cannot recommend it as a routine standard on the basis of one case.</p><p><strong>KEYWORDS </strong> larynx; penetrating neck injury; vocal cord; reconstruction, neck exploration</p>