Penetrating injuries of the neck

ABSTRACT

Penetrating injuries of the neck are potentially dangerous, causing high rates of morbidity and mortality due to their association with severe bleeding and serious damage to the vital structures in the cervical region. To know the incidence and distribution of these injuries on the anatomical zones of the neck and the damage of the vital structures in the cervical region and their early surgical management. A prospective study on 52 patients of both civilian and military personnel with penetrating neck injuries attended the casualty department at Alyarmouk hospital over a period of 7 months from June-December 2006. Fifty patients [96.15%] were males. Twenty four patients [46.15%] were in their third decade. Twenty six patients [50%] were injured by shrapnel of explosives, 23 patients [44.21%] by bullets and 3 patients [5.77%] by unknown objects. Thirty six patients [69.23%] were injured at zone 2, 11 patients [21.15%] at zone 3 and 5 patients [9.62%] at zone 1. Twenty nine patients [55.77%] had laryngeal and tracheal injuries. Thirteen patients [25%] had pharyngeal and esophageal injuries. Four patients [7.7%] had recurrent laryngeal nerve injury. Nine patients [17.3%] had vascular injuries 6 arterial and 3 venous. One patient had vertebral and spinal cord injury. Forty one patients [78.86%] had tracheostomy operations, and 13, [25%] had neck exploration. Six patients [11.54%] treated conservatively. Nine patients [17.3%] have died. Male patients at their middle age were the predominant victims either by shrapnel or by bullets. Zone 2 was most commonly affected followed by zone 3 and zone 1. Laryngo-tracheal, pharyngo-esophageal and vascular structures were mostly involved. Tracheostomy and neck exploration were the main urgent operations performed for them. The high mortality reflected the serious nature of these injuries