Management of twenty patients with neck trauma in Khartoum ENT Hospital

Abstract

Background: Neck trauma is a great surgical challenge, because there are multi organ and systems involved.
Objective: To study the clinical presentation, management and outcome of twenty patients presented to Khartoum ENT Hospital with neck trauma.
Methods: This is a prospective study conducted in Khartoum ENT Hospital, Sudan during the period 1998- 2008. A total number of 20 patients presented to our unit with neck trauma were included in the study. All patients were admitted to the hospital, assessed and managed according to the magnitude of trauma.
Results: The age varied from 5 to 40years, with mean age (±SD) 28 years (±9). Male to female ratio was 2:1. Most of the patients presented to the Hospital between 1-6 hours after trauma. The mechanism of neck trauma was blunt trauma in 16(80%) patients and penetrating wound in 4(20%) patients. The distribution of injuries in neck zones were 17(85%) patients in zone II, 2(10%) patients in zone III and one patient in zone I. Tracheal injury and pharyngeal injury were seen in 4(20%) patients each, laryngeal injury in 5(25%) patients, and salivary gland injury in 1(5%) patient.
Surgical exploration and tracheostomy were done in 4(20%) patients. tracheostomy alone was performed in 7(35%) patients with blunt trauma. Conservative management without surgical intervention was done in 9(45%) patients. The common complications in this study were vocal cord paralysis and subglottic stenosis in 2(10%) patients each, while surgical emphysema and haemothorax was seen in one patient.
Conclusion: Zone II injures were the commonest injuries. Early presentation and proper management of patients with neck trauma carry good prognosis.

Key words: neck trauma, clinical presentation, management.