Penetrating Neck Trauma

Question 1

Stable Penetrating Neck Trauma

Violates Platysma

Answer 1

Look for Hard Signs of Injury:

If (+): Operating room or interventional angiography
If (-) : Look for Soft signs of Injury

Question 2

Stable Penetrating Neck Trauma

No Injury to Platysma

Answer 2

Observe

Question 3

UNSTABLE Penetrating Neck Trauma

Answer 3

OR or Interventional angiography

And REPAIR Injury

Question 4

WITH SOfT signs of Injury

Answer 4

CT angiography

Question 5

Suspicion for pharyngo-esophageal injury

Answer 5

Esophagram or esophagoscopy*
*Combined esophagram and esophagoscopy have 100%
sensitivity

(=): end
(+): IV antibiotics for 7–10 days,
nasogastric or total parenteral nutrition,
operative repair or conservative management

Question 6

Suspicion for laryngotracheal injury

Answer 6

Panendoscopy

(-): end
(+): Operative repair unless small mucosal or
undisplaced laryngeal framework fracture

Question 7

Suspicion for vascular injury

Answer 7

CTA* Color Doppler angiography
*Angiography if CTA indeterminate

(-): End
(+): OR or interventional angiography