![]() ![]() Through the thyrohyoid space, the undamaged vocal cords could be visualized. The injury had cut open the larynx through the thyrohyoid membrane and ligaments and extended obliquely upwards and backwards. The laceration had penetrated the platysma to involve the medial portions of bilateral sternohyoid and thyrohyoid muscles. Externally the neck wound was an oblique 5 cm long laceration on the anterior part of the neck starting 2 cm from the left side at the midpoint of the anterior border of the sternocleidomastoid muscle, and extending medially and slightly obliquely downwards across the midline of the neck to the right side about 2 cm above the suprasternal notch. There was a bulge on the posterior pharyngeal wall produced by impaction of a large foreign body in the retropharyngeal space. Direct laryngoscopic examination revealed edema, hematoma, avulsed mucosa and lacerations of the epiglottis and muscles of the posterior pharyngeal wall. The X-ray of the neck in lateral view (Figure1), revealed a 3 mm thick and 5.5 cm long radio-opaque shadow in the retropharyngeal space, anterior to the vertebral bodies of C3 and C4. On arrival at the hospital emergency department, the patient was found to be haemodynamically stable with no active bleeding and with no evidence of cervical spine injury. Case reports Case 1Ī 36-year-old man who was allegedly assaulted and stabbed on the front of his neck with a broken glass bottle, was initially treated at a primary healthcare centre where his trachea was intubated and then transferred to the central hospital. We present 3 cases of PNI with associated laryngeal injuries and discuss the characteristics and challenges in their management especially in resource-constrained settings. ![]() The optimal management of PNIs however remains controversial. Prompt and effective management is therefore essential. Mortality rate for PNI in civilian populations range between 3 - 20 % with about 50% due to exsanguinating haemorrhage from vascular injuries. Trauma to the aerodigestive or vascular structures may be life-threatening because of airway compromise or torrential haemorrhage. They account for approximately 5–10 % of all trauma cases presenting to the Emergency department and pose a high risk for major morbidity and mortality because of the several vital structures that traverse or reside in this relatively small area of the body. Penetrating neck injuries (PNI) are defined as injuries that extend deep to, or penetrate the platysma. Penetrating neck injuries, laryngeal trauma, neck trauma, laryngotracheal injuries, airway trauma Introduction We present 3 cases illustrating different mechanisms of occurrence and highlighting some of the challenging associated with management with suggestions for optimal management. Management can be challenging and sometimes controversial. These injuries could be intentional or accidental and the mechanisms and severity vary. Injuries involving the larynx are especially dangerous because of the risk of airway compromise. Penetrating neck injuries are injuries that penetrate the platysma and are a major cause of morbidity and mortality because of the vital structures confined in the neck area.
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