Computed Tomographic Angiography as an Aid to Clinical Decision Making in the Selective Management of Penetrating Injuries to the Neck: A Reduction in the Need for Operative Exploration

Osborn, Timothy M.; Bell, R. Bryan; Qaisi, Waleed G.; Long, William B.

doi:10.1097/ta.0b013e3181271b32

Cited by 87 publications

(84 citation statements)

References 25 publications

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“…In the past, routine neck exploration was the standard treatment for PNI, which led to a high rate of negative neck exploration (a quarter of patients) and significant associated morbidity (half of patients) 6,8,12,13 .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Management of penetrating neck injuries

Waes¹,

Cheriex²,

Navsaria

et al. 2011

British Journal of Surgery

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Section: Discussionmentioning

confidence: 99%

“…It is based on clinical examination and additional investigations 13,14 . Together, they have been shown to be reliable indicators of clinically significant injury, with a sensitivity of 93-95 per cent and a negative predictive value of 97 per cent 13 -17 .…”

Section: Discussionmentioning

confidence: 99%

Management of penetrating neck injuries

Waes¹,

Cheriex²,

Navsaria

et al. 2011

British Journal of Surgery

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“…5,7 Most importantly, in all of the studies that directly evaluated selective nonoperative management of PNIs, none of the patients who were observed required delayed surgery for an initially occult injury. 5,7,19,[23][24][25] 5. Finally, although rare, esophageal perforations from PNIs can be difficult to diagnose, and delayed diagnosis and treatment result in increased morbidity and mortality.…”

Section: Cta May Have Technical Limitations When Metallicmentioning

confidence: 99%

“…Although some of the literature suggests that CTA is only marginally better than physical examination for determining the need for surgery, 10,13 other studies suggest that CTA is as accurate as angiography in identifying vascular injuries in PNIs 15 and that the use of CTA in stable PNI patients limits unnecessary surgical intervention. 19 2. Doppler ultrasonography has also been found to be accurate in detecting clinically significant vascular lesions in PNIs, with reports of 95 to 100% sensitivity and 99 to 100% specificity.…”

Section: Cta May Have Technical Limitations When Metallicmentioning

confidence: 99%

Conservative management of laryngeal perforation in a rural setting: case report and review of the literature on penetrating neck injuries

Kolber

Aspler

Sequeira³

2011

CJEM

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Penetrating neck injuries (PNIs) are infrequent but can result in significant morbidity and mortality. Although surgical management of unstable patients with penetrating neck trauma is the standard of care, management of stable patients remains controversial owing to the possibility of occult injuries. Recent studies suggest that physical examination and ancillary imaging may be sufficiently accurate to diagnose or rule out surgically significant injuries in PNI. We report a patient with a laryngeal perforation who was managed conservatively in a rural hospital without complications and review the literature pertinent to cases of this nature. RÉ SUMÉLes traumatismes pé né trants de la ré gion du cou sont rares, mais peuvent entraîner une morbidité et une mortalité importantes. Bien que la prise en charge chirurgicale de patients instables pré sentant un traumatisme pé né trant de la ré gion du cou soit la norme, la prise en charge des patients stables demeure controversé e en raison de la possibilité de blessures latentes. De ré centes é tudes suggè rent que l'examen physique et l'imagerie auxiliaire peuvent ê tre suffisamment pré cis pour poser un diagnostic ou exclure des blessures importantes sur le plan chirurgical dans les cas de traumatismes pé né trants du cou. Nous pré sentons le cas d'un patient au larynx perforé qui a fait l'objet d'un traitement conservateur dans un hô pital rural sans complications. Nous passons aussi en revue la litté rature pertinente de cas semblables.

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“…Neck injuries are classified in three zones. [2] In management of traumatic head and neck injuries, it is still controversial to make immediate surgical exploration or to make serial physical examinations [3] (including angiography, with endoscopic examinations and selective surgical exploration).…”

mentioning

confidence: 99%

Larynx, Hypopharynx And Mandible Injury Due To The External Penetrating Neck Injury

Acar¹,

Tekın²,

Çam³

et al. 2013

Ulus Travma Acil Cerrahi Derg

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Esophageal and laryngeal injuries due to ballistic injuries are seldom encountered. Ballistic external neck traumas generally result in death. Incidence of external penetrant neck injuries may vary between 1/5000-137000 patients among emergency service referrals. Vascular injuries, esophagushypopharynx perforations, laryngotracheal injuries, bony fractures, and segmentations may be encountered in external neck traumas. Here we report a 27-year-old male patient who was referred to our emergency department and presented with hyoid bone fracture, multiple mandibular fractures, and hypopharynx perforation due to a ballistic external neck injury.

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Computed Tomographic Angiography as an Aid to Clinical Decision Making in the Selective Management of Penetrating Injuries to the Neck: A Reduction in the Need for Operative Exploration

Cited by 87 publications

References 25 publications

Management of penetrating neck injuries

Management of penetrating neck injuries

Conservative management of laryngeal perforation in a rural setting: case report and review of the literature on penetrating neck injuries

Larynx, Hypopharynx And Mandible Injury Due To The External Penetrating Neck Injury

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