The importance of anatomical zonal classification in the early management of penetrating neck injuries

2020 ◽  
Vol 16 (1) ◽  
pp. 74-77
Author(s):  
Khalid D. Al-Assal ◽  
Jawad A Thuhabat ◽  
Ahmed A Al-Khafaji
Keyword(s):  
Foreign Bodies ◽  
Recurrent Laryngeal Nerve Injury ◽  
Neck Injuries ◽  
Penetrating Injuries ◽  
Early Management ◽  
Penetrating Neck Injury ◽  
Laryngeal Nerve Injury ◽  
Military Patients ◽  
Terrorist Bombing

Background: Penetrating neck injuries are common problem in our country due to increasing violence, terrorist bombing and military operations.These injuries are potentially life threating and need great attention and proper management.Objective: The aim of this study is to focus on the importance of anatomical zonal classification of the neck in the management of penetrating injuries of the visceral compartment of the Neck.Methods :70 patients with various injuries who were managed at causality unit and Otolaryngology department in Al-Kindy Teaching Hospital during aperiod from January 1st 2015 to October 31st 2015.The study carried on those patient depending on proper clinical examination and their urgent management.Results : Both civilian and military patients were admitted to the hospital, 34 patients (47.2%) in their 20s age group, while only 2 (2.8%) in 60s.High percentage of penetrating neck injuries in zone , 48 patient (68.6%) and lowest in zone , 6 patients (8.5%).40 patients (57.1%) presented with tracheal and laryngeal injuries and 12 patients (17.5%) were with pharyngeal injuries, 4 patients (5.7) were with recurrent laryngeal nerve injury and 13 patients (18.5%) presented with vascular injuries.Radiological examination done for 53 patients (75%) and we found foreign bodies in 30 patients (56.6%), tracheal deviation in 4 patients (7.5%) and emphysema in 19 patients (35.8%).Tracheostomy done in 51 patients (72.8%) neck, exploration in 20 patients (28.5%) and a 9 patients (12.8%) treated conservatively.Conclusion: Zonal classification of penetrating neck injuries was helpful in the management. Our study explains demographics and location of the injuries. Young men involved in violence and bombing was at high risk.Zone with involvement of trachea, larynx and pharynx were most common areas of injuries.RecommendationsAnatomical zone classification should be used as a guideline in management of penetrating neck injuries. (Trauma lifesaving guideline).Tracheostory should be practiced by every doctor in casualty unit. Team of surgeons and anaesthiologist should be always ready for any intervention with patient present to the casualty unite with a penetrating neck injury. Emergency medicine medical practice must be presents in every casualty unit to deal with insults.Aim of the study1.To recognize penetrating injuries of the neck according to the anatomic neck zones.2.Identify the outcome of their treatment

Foreign body: denture in oesophagus: a case report

2019 ◽  
Vol 11 (5) ◽  
pp. 226-227
Author(s):  
Nitin Arora ◽  
Daljeet Kaur ◽  
Urvashi Mishra ◽  
Radhika Bhateja ◽  
Nikhil Arora
Keyword(s):  
Case Report ◽  
Early Intervention ◽  
Foreign Body ◽  
Early Detection ◽  
Early Treatment ◽  
Foreign Bodies ◽  
Recurrent Laryngeal Nerve Injury ◽  
Laryngeal Nerve ◽  
Upper Gi ◽  
Laryngeal Nerve Injury

identally swallowed dentures are one of the most common foreign bodies of upper digestive tract in elderly people and it can lead to severe complications. Complications ranging from oesophageal rupture, mediastinitis, haemetemesis, and recurrent laryngeal nerve injury has been reported. Therefore, an early detection and an early intervention are important. We are reporting a case of accidentally swallowed denture. After the diagnosis of an impacted denture was made, upper GI Oesophagoscopy was done and it was removed in emergency OT. This case highlights the importance of an early treatment in order to avoid complications.

Correlation between Stroboscopy and Electromyography in Laryngeal Paralysis

1993 ◽  
Vol 102 (11) ◽  
pp. 852-857 ◽  
Author(s):  
John Kokesh ◽  
Lawrence R. Robinson ◽  
Paul W. Flint ◽  
Charles W. Cummings
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Therapeutic Intervention ◽  
Vocal Fold ◽  
Recurrent Laryngeal Nerve Injury ◽  
Laryngeal Nerve ◽  
Previous Surgery ◽  
Laryngeal Paralysis ◽  
The Status ◽  
Laryngeal Nerve Injury ◽  
Vocal Fold Motion

Twenty patients with vocal fold motion impairment were reviewed to correlate the findings of electromyography (EMG) and stroboscopy. The causes of motion impairment were idiopathic, previous surgery with recurrent laryngeal nerve injury, neck and skull base trauma, and neoplasm. The EMG studies were analyzed to assess the status of innervation of the immobile vocal fold. The presence or absence of the mucosal wave prior to therapeutic intervention was determined with stroboscopic examination. Eight of 10 patients with EMG evidence of reinnervation or partial denervation were found to have mucosal waves, and 3 of 10 patients with EMG evidence of denervation were found to have mucosal waves. Six patients developed mucosal waves after surgical medialization, despite evidence of denervation by EMG criteria. These findings support the premise that tension and subglottic pressure, rather than status of innervation, determine the presence of the mucosal wave.

scholarly journals Recurrent laryngeal nerve injury in thyroid surgery: a review

2012 ◽  
Vol 83 (1-2) ◽  
pp. 15-21 ◽  
Author(s):  
Nathan James Hayward ◽  
Simon Grodski ◽  
Meei Yeung ◽  
William R. Johnson ◽  
Jonathan Serpell
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Nerve Injury ◽  
Thyroid Surgery ◽  
Recurrent Laryngeal Nerve Injury ◽  
Laryngeal Nerve ◽  
Laryngeal Nerve Injury

Contemporary outcomes of aortic arch hypoplasia and coarctation repair in a tertiary paediatric cardiac surgery centre

2021 ◽  
pp. 1-6
Author(s):  
Amr Ashry ◽  
Amer Harky ◽  
Abdulla Tarmahomed ◽  
Christopher Ugwu ◽  
Heba M. Mohammed ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Circulatory Arrest ◽  
Recurrent Laryngeal Nerve Injury ◽  
Coarctation Repair ◽  
Aortic Arch Reconstruction ◽  
Retrospective Data Collection ◽  
Laryngeal Nerve Injury ◽  
Neonates And Infants ◽  
Arch Reconstruction ◽  
Aortic Arch Hypoplasia

Abstract Objectives: There are several studies reporting the outcomes of hypoplastic aortic arch and aortic coarctation repair with combination of techniques. However, only few studies reported of aortic arch and coarctation repair using a homograft patch through sternotomy and circulatory arrest with retrograde cerebral perfusion. We report our experience and outcomes of this cohort of neonates and infants. Methods: We performed retrospective data collection for all neonates and infants who underwent aortic arch reconstruction between 2015 and 2020 at our institute. Data are presented as median and inter-quartile range (IQR). Results: The cohort included 76 patients: 49 were males (64.5%). Median age at operation was 16 days (IQR 9–43.25 days). Median weight was 3.5 kg (IQR 3.10–4 kg). There was no 30 days mortality. Three patients died in hospital after 30 days (3.95%), neurological adverse events occurred in only one patient (1.32%) and recurrent laryngeal nerve injury was noted in four patients (5.26%). Only three patients required the support of extracorporeal membrane oxygenation (ECMO) with a median ECMO run of 4 days. Median follow-up was 35 months (IQR 18.9–46.4 months); 5 years survival was 93.42% (n = 71). The rate of re-intervention on the aortic arch was 9.21% (n = 7). Conclusion: Our experience shows excellent outcomes in repairing aortic arch hypoplasia with homograft patch under moderate to deep hypothermia with low in-hospital and 5 years mortality rates.

scholarly journals Cutaneous fistula due to remaining foreign bodies after penetrating neck injury

2013 ◽  
Vol 2013 (oct04 1) ◽  
pp. bcr2013201278-bcr2013201278 ◽  
Author(s):  
W. M. P. F. Bosman ◽  
E. D. Ritchie ◽  
S. A. da Costa
Keyword(s):  
Foreign Bodies ◽  
Neck Injury ◽  
Cutaneous Fistula ◽  
Penetrating Neck Injury

Observations of recurrent laryngeal nerve injury and recovery using a rat model

2009 ◽  
Vol 119 (8) ◽  
pp. 1644-1651 ◽  
Author(s):  
Belachew Tessema ◽  
Rick M. Roark ◽  
Michael J. Pitman ◽  
Philip Weissbrod ◽  
Sansar Sharma ◽  
...  
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Nerve Injury ◽  
Rat Model ◽  
Recurrent Laryngeal Nerve Injury ◽  
Laryngeal Nerve ◽  
Laryngeal Nerve Injury

scholarly journals A current view on recurrent laryngeal nerve injury in total thyroidectomy

2021 ◽  
Vol 28 (1) ◽  
pp. 7-12
Author(s):  
Lucian ALECU ◽  
◽  
Iulian SLAVU ◽  
Adrian TULIN ◽  
Vlad BRAGA ◽  
...  
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Total Thyroidectomy ◽  
Nerve Injury ◽  
Unintentional Injury ◽  
Recurrent Laryngeal Nerve Injury ◽  
Laryngeal Nerve ◽  
Current View ◽  
Pubmed Database ◽  
Laryngeal Nerve Injury ◽  
The Moment

Introduction: Recurrent laryngeal nerve damage during total thyroidectomy was, is, and probably will be in the near future the Achilles’ heel of total thyroidectomy. Material and method: To perform the research we used the PubMed database. The questions were conceived to respect the PICOS guidelines. The PRISMA checklist was used to filter the results. The search was structured following the words: „recurrent laryngeal nerve injury” AND „total thyroidectomy”. Results: A total of 60 papers were identified. We excluded 12 papers as they were duplicates. From the 48 papers left, another 4 could not be obtained. Another 3 papers from the 44 left were excluded due to the fact they were not written in English. One paper was excluded as the subject did not follow our research purpose. 40 papers were left for analysis and discussion. Conclusion: To prevent recurrent laryngeal nerve lesions, at the moment in the literature there is no consensus. Unintentional injury to the recurrent laryngeal nerve is predictable but not an avertible situation thus bilateral lesions still represent a dramatic situation across the world for the patients and the operating surgeon.

scholarly journals Nail Gun Injury: An Unusual Presentation as Tracheal Foreign Body

2015 ◽  
Vol 7 (2) ◽  
pp. 57-59
Author(s):  
Nikhil Arora ◽  
Kirti Jain ◽  
Ramanuj Bansal
Keyword(s):  
Foreign Body ◽  
High Velocity ◽  
Foreign Bodies ◽  
Unusual Presentation ◽  
Penetrating Injuries ◽  
Nail Gun Injury

ABSTRACT Foreign bodies in trachea usually result from accidental slippage of an oral object while external penetrating injuries arising from high velocity projectile from a nail gun are rare. Here, we report a case in which a high velocity nail from a nail gun penetrated the sternum during the nailing and benignly presented to us as a foreign body in the trachea. How to cite this article Arora N, Jain K, Malhotra V, Bansal R. Nail Gun Injury: An Unusual Presentation as Tracheal Foreign Body. Int J Otorhinolaryngol Clin 2015;7(2):57-59.

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