Добавил:
Sekretar
kiopkiopkiop18@yandex.ru
t.me/Prokururor I Вовсе не секретарь, но почту проверяю
Опубликованный материал нарушает ваши авторские права? Сообщите нам.
Вуз:
Предмет:
Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_4581_Библиотеки_им_академика_М_И_Перельмана
.pdf
108
10 Injuries oftheNeck
ries require immediate surgical treatment.
Angiography should generally be reserved for
hemodynamically stable patients. However, if it
can be performed in conjunction with an open
approach, it may facilitate in obtaining proximal
vessel control as well as in identifying vessel
injury during emergent surgical intervention.
Although open surgical technique remains the
gold standard for all zones of penetrating carotid
injuries, there is an increasing trend to use a combined endovascular approach (DuBose et al.
2008; Madsen etal. 2016a).
Conventional open surgical approaches
involve surgical repair or surgical ligation. All
possible attempts should be made at surgical
repair, as it offers the best chance of survival with
decreased risks of permanent neurologic decits.
Surgical repair consists of primary arteriography,
end-to-end anastomosis, vein grafting,
polytetrauoroethylene (PTFE) patching, and
transposition of external carotid artery to injured
internal carotid artery (Lee etal. 2014).
Most authors agree to recommend surgical
repairs to patients who present without neurologic decits (Ramadan et al. 1995; Gillespie
2011; Reva etal. 2011). Zone II injuries are gen-
erally easily accessible, whereas zone III injuries
may sometimes require mandibulotomy, while
zone I injuries may require sternotomy for adequate exposure.
The optimal surgical management of penetrating carotid injury patients presenting with neurologic decits remains controversial (O’Banion
etal. 2022). Due to their concern of converting an
ischemic stroke into a hemorrhagic one that can
occur after reestablishment of cerebral ow, several authors advise against surgical repair (Lee
etal. 2014). Contrastingly, Reva etal. (2011) rec-
ommended surgical repair even in the presence of
prolonged neurologic damage and irrespective of
preoperative neurologic decits, as improvement
or resolution of initial neurologic impairment has
been reported after surgical repair (Reva et al.
2011). Overall stroke rate has been reported to be
17% (23% operative vs. 10% nonoperative,
p=0.076) and the rate of stroke or death to be
27% (64% operative, 36% nonoperative) in a
recent review of 102 patients with penetrating
carotid injuries (PROspective Observational
Vascular Injury Trial; O’Banion et al. 2022).
Factors associated with stroke were lower
Glasgow Coma Scale (GCS) and completion
angiography. Likewise, lower GCS and Injury
Severity Score (ISS) were associated with stroke
or death (O’Banion etal. 2022).
Endovascular techniques, either alone or in
conjunction with an open approach, have gained
popularity in the management of penetrating
carotid injuries. They can be useful in zone III
injuries near the skull base where surgical exposure and repair of the distal internal carotid artery
can be challenging. Furthermore, they can be performed without general anesthesia allowing for
monitoring of the patients’ neurologic status during surgical intervention.
Du Toit etal. (2009) reviewed 19 patients with
penetrating carotid artery injuries (proximal
common carotid, distal internal carotid injuries),
who were treated endovascularly. Another 109
patients (primarily accessible zone II lesions)
were treated with open surgery during the same
period. Only patients who would benet the most
were elected to be treated endovascularly. The
vessels involved were 14 proximal common
carotid arteries and ve distal internal carotid
arteries. The pathology included ten false aneurysms and nine arteriovenous stulae. Three
patients presented with neurological dysfunction
(two patients with hemiparesis, one with coma).
All three had signs of ischemic cerebral infarction on preoperative CT scan. Four patients were
lost to follow-up. Of the 14 patients available for
follow-up, 2 (14%) had occluded stent-grafts, of
which 1 (7%) resulted in a stroke. Two patient
deaths occurred, one as a result of preoperative
ischemic brain damage and the other as a result
of suicide 13months after successful treatment.
The 30-day stroke and mortality rates were both
5%, and no graft sepsis or other stent-graftrelated complications were recorded. The authors
concluded that stent-grafts will be more liberally
considered in the treatment of penetrating carotid
artery injuries in the future (du Toit etal. 2009).
Surgical ligation is associated with notably
higher rates of mortality and stroke and should
only be reserved for situations where surgical
10.5 Injuries of the Pharynx and the Esophagus
Данная книга находится в списке для перевода на русский язык сайта https://meduniver.com/
109
repair is not feasible. The reported indications
vary and remain controversial among different
studies. The indications put forth by Navsaria
etal. (2002) include established ischemic infarct
or severe cerebral edema seen on CT, technically difcult high ICA injuries, coma of more
than 4–6-h duration, absent backow at surgery,
and neurologically intact patients with occlusion seen on angiography. Attention should be
paid at the level of ligation and cover of the
stump with healthy tissue in order to avoid
delayed rupture of the vessel stump from infection (Gillespie 2011).
Despite signicant advancement in understanding carotid trauma, there is a clear need for
prospective, randomized clinical studies, with
large sample sizes, to address several controversies that exist in the treatment of these serious
injuries (O’Banion etal. 2022).
10.5 Injuries ofthePharynx
andtheEsophagus
Penetrating injuries to the hypopharynx and to
the esophagus are uncommon because of the central and protected position of these anatomical
structures. An incidence of 37 per 100,000 trauma
patients was reported in a recent analysis of the
National Trauma Data Bank for the years 2010–
2015 (Xu et al. 2019). Traumatic injury of the
esophagus was observed 16 times more frequently with penetrating injuries (257 per
100,000) than with blunt injuries (16 per 100,000)
(Xu etal. 2019). Most busy trauma centers report
an average of 2–9 cases per year (Asensio etal.
1997; Madiba and Muckart 2003). Esophageal
injuries occurred in 2–6% of neck injuries
(Ngakane etal. 1990; Madiba and Muckart 2003;
Tatum etal. 2019). Pharyngoesophageal injuries
were diagnosed in 8% and 8.9% of 510 and 203
patients with PNI, respectively (Thoma et al.
2008; Madsen et al. 2016a). The overall inci-
dence of aerodigestive trauma reported by
Vassiliu et al. (2001) in a series of 1560 admissions with blunt or penetrating neck injury was
4.9% (10.2% for gunshot wounds, 4.6% for stab
wounds, and 1.2% for blunt trauma).
Signs and symptoms of dysphagia/odynophagia, hematemesis, subcutaneous crepitance, retropharyngeal air, and injuries to adjacent
structures (Table 10.1) are strong indicators of
esophageal injury. Twenty-eight out of 220
patients (13%) with odynophagia associated with
neck trauma were diagnosed with esophageal
injury (Madiba and Muckart 2003). These ndings were in keeping with those of another study
(Ngakane etal. 1990), where only 14% of patients
with odynophagia were shown to have cervical
esophageal injury. Both these studies conrm
that odynophagia alone is not pathognomonic of
cervical esophageal injury.
Goudy et al. (2002) reviewed 236 patients
with the diagnosis of aerodigestive tract injury or
subcutaneous emphysema. Nineteen patients
were identied with cervical emphysema or cervical crepitance or both. Location of the injury
was tracheolaryngeal in 37%, hypopharyngeal in
27%, oropharyngeal in 16%, esophageal in 5%,
and unidentied in 15% of patients. Abnormalities
were found by direct laryngoscopy and/or esophagoscopy in 80% of the patients. The diameter of
the average laceration of the upper aerodigestive
tract was 1.6cm (Goudy etal. 2002).
Retropharyngeal air on lateral neck X-ray was
identied in 15/28 patients (55%), clinical surgical emphysema in 7/28 (25%), and saliva dribbling from the wound in 4/28 (14%) in the series
reported by Madiba and Muckart (2003).
Delay in diagnosis is the most important contribution to the mortality associated with injuries
to the esophagus, estimated to be approximately
20% (Asensio etal. 1997; Ofah and Hall 2012).
Delay in treatment from 12 to 24h allows enough
leakage of saliva and bacteria, as well as reuxed
acid, pepsin, and bile into the surrounding loose
areolar tissues, to produce suppurative infection
and an intense necrotizing inammatory response
(Madiba and Muckart 2003). This inammation
may allow rapid spread of infection into the
mediastinum under the force of gravity, and negative intrathoracic pressure of the leakage is not
drained away from the deep neck spaces
(Armstrong etal. 1994). This increases morbidity
and mortality, and attempting repair in these
patients is unlikely to succeed (Madiba and
110
10 Injuries oftheNeck
Muckart 2003). Asensio etal. (1997) attempted
to correlate the time to establish a diagnosis with
outcome including death, surgical intensive care
unit length of stay, and esophageal related complications. Thirty-six patients survived to reach
the operating room, 18 in the no preoperative
evaluation group and 17in the preoperative evaluation group. Average length of time to the operating room was 16.7 h in the preoperative
evaluation group and 1.4h in the no preoperative
evaluation group. Twelve complications (all
esophageal related) occurred among seven
patients in the preoperative evaluation group, and
seven complications (ve esophageal related)
occurred among seven patients in the no preoperative evaluation group. Despite the nonstatistical signicance of the results, the authors
concluded that rapid diagnosis and denitive
repair of esophageal injury should be made a
high priority.
Early investigation is of great importance. It
conrms the site of injury, identies the extravasation from the esophagus, documents the site of
the leak, and demonstrates if it is contained or not
(Madiba and Muckart 2003). The most commonly used modalities are contrast esophagography (water-soluble contrast media), exible
esophagoscopy, and recently multi-detector computer tomography angiography (MDCTA). The
proximity or otherwise the wound trajectory can
be assessed on MDCTA. Of 383 patients with
PNI investigated with computed tomography
angiography (CTA), a total of 38 patients were
diagnosed with digestive tract injury, and all of
these patients were found to have deep surgical
emphysema on CTA.Another 126 patients also
had deep surgical emphysema on CTA but no
digestive tract injury. The positive predictive
value of deep surgical emphysema for the diagnosis of conrmed digestive tract injury in PNI
was 22.7%. The authors concluded that the presence of deep surgical emphysema is nonspecic
but warrants further investigation. The absence of
deep surgical emphysema in the deep cervical
fascial planes virtually excludes surgically signicant aerodigestive tract injury (Madsen etal.
2016c). Paladino etal. (2021) conducted a litera-
ture search on penetrating neck trauma (PNT)
and CT scan and concluded that CTA alone is not
sufcient to exclude esophageal injuries in
PNT.They advocate additional diagnostic interventions if there is remaining concern for esophageal injury.
Where clinical and radiological suspicion is
high or frank injury to the esophagus has been
identied on MDCTA, contrast swallow assessment (if the patient is able to comply with the
procedure) or endoscopy or both will be indicated (Ofah and Hall 2012; Bodanapally etal.
2016).
Esophageal injuries may be managed either
conservatively or surgically. Both conservative
and operative approaches are accompanied by a
course of antibiotics, nothing by mouth, and surgical nutrition. Dolgin etal. (1992) reviewed ten
patients from two institutions in the United States
with pharyngoesophageal injuries who were
treated by a conservative medical management
approach. All patients were treated with broadspectrum intravenous antibiotic therapy and no
oral feeding. There were no complications or
need for surgical treatment in any of the cases.
This approach is relatively safe resulting in no
disability or prolonged hospitalization of the
patients in selected cases and cost effective
(Madsen et al. 2018a, b; Tatum et al. 2019).
Triggiani and Belsey (1977) and later Bryant and
Cerfolio (2007) and others share the same opinion for highly selected cases (small perforations),
which can heal spontaneously. Madiba and
Muckart (2003) underlined the notion that the
most important aspect of the management of
these injuries is deciding whether to institute
conservative or operative management.
Nonoperative management for contained extravasation and surgical exploration for not contained
ones is the preferred mode of treatment (Madiba
and Muckart 2003; Bryant and Cerfolio 2007).
The length of time required for closure is variable
and has been reported between 5 days and
3weeks (Madiba and Muckart 2003).
Surgical management of esophageal injuries
presenting to hospital within 12h of injury is by
direct suture repair and drainage (Asensio etal.
2001; Madiba and Muckart 2003; Madsen etal.
2018a, b; Raff etal. 2020). Patients presenting
10.6 Neurologic Injuries
Данная книга находится в списке для перевода на русский язык сайта https://meduniver.com/
111
with delay should ideally undergo debridement
and drainage without attempted repair (Triggiani
and Belsey 1977; Ngakane etal. 1990; Madiba
and Muckart 2003). A single-layer repair seems
to sufce, and a loose approximation of the
esophageal wall is acceptable as long as salivary
leak is anticipated and adequately drained externally away from other deep neck spaces and
mediastinum (Armstrong et al. 1994). Patients
managed with stenting had an increased rate of
esophageal leak (80.0% vs. 22.6%, p = 0.02)
compared with patients who underwent operative primary repair (Raff etal. 2020). Stanley
etal. (1997) reported that 22% of patients with
hypopharyngeal injuries below the tips of the
arytenoid cartilages and 39% of the patients
with a cervical esophageal injury developed
either a deep neck infection that required drainage or a postsurgical salivary stula. Persistent
leak was reported in 17% of cases and mediastinitis in 7% (Madsen et al. 2018a, b).
Complication rates were higher in blunt compared with penetrating mechanisms (100% vs.
31.8%) despite similar Injury Severity Score
and neck/chest/abdomen Abbreviated Injury
Scale (Raff etal. 2020).
Some surgeons suggest diversion of the cervical esophagus to the skin for injuries older than
16 h and those with extensive tissue loss
(Triggiani and Belsey 1977; Feliciano et al.
1985). Others suggest its use when purulence has
already advanced to the mediastinum, where
esophageal violation extends below the level of
the thoracic inlet, in cases of direct contamination of the mediastinum as well as in patients
with failed primary repair (Ngakane etal. 1990;
Armstrong et al. 1994; Madiba and Muckart
2003). The T-tube splinting method used by
Hatzitheophilou etal. (1993) in four patients who
presented with a delay of more than 24 h (one
death) has not received wide acceptance.
Resection and anastomosis have also been
reported (Asensio etal. 2001).
Some authors advocate the use of muscle aps
in cases of a concomitant tracheal injury for separation of the tracheal wall (Armstrong etal. 1994;
Asensio etal. 2001). Other authors have reported
successful repair of combined tracheal and
esophageal injury without muscle interposition
(Mohlala etal. 1994).
Surgical and conservative methods of management should not be viewed competitively
(Keszler and Buzna 1980; Madiba and Muckart
2003). Both methods have a role, and each patient
should be managed on an individual basis. The
selective management policy has been shown to
be safe and effective provided that patients are
closely monitored in the hospital (Ngakane etal.
1990; Madiba and Muckart 2003).
Complications were reported in 53.5% of
patients after treatment in a large series of 405
patients from 34 trauma centers in the United
States (Asensio etal. 2001). Logistic regression
analysis identied as independent risk factors for
the development of esophageal related complications time delays in preoperative evaluation (OR
3.13), American Association for the Surgery of
Trauma Organ Injury Scale Grade >2 (OR 2.62),
and resection and diversion (OR 4.47) (Asensio
etal. 2001).
The mortality rate has been reported between
7% (Madiba and Muckart 2003; Madsen et al.
2018a, b; Raff et al. 2020) and 19% (Asensio
et al. 2001). Mortality is mainly attributed to
associated vascular injuries, intrathoracic penetration, combined airway and esophageal injury,
septic complications of repair, dehiscence, as
well as missed injuries (Feliciano et al. 1985;
Hatzitheophilou etal. 1993; Asensio etal. 1997).
10.6 Neurologic Injuries
Injury to cervical nerve structures is not infrequent
in patients with penetrating neck trauma. Nerve
injuries are detected either during neck exploration or on follow-up. Therefore, follow- up at
1week after discharge and at 3months would be
reasonable (Nason etal. 2001). In a series of 134
neck wounds penetrating the platysma, there were
signicant injuries in 34 (ca. 25%). In 13/34, a
major nerve injury (brachial plexus 6, accessory
nerve 5, phrenic nerve 1, recurrent nerve 1) was
identied. One brachial plexus injury and one
accessory nerve injury were detected on followup. Minor sensory decits from the greater auricu-
112
10 Injuries oftheNeck
lar nerve were noticed in three patients. Long-term
disability was documented in three patients managed by observation alone and six patients managed by surgical exploration: phrenic (1), recurrent
laryngeal (1), accessory (3), and brachial plexus
(4) nerve injuries (Nason etal. 2001).
Brachial plexus injuries often present major
problems of diagnosis and management (Leffert
1974; Dubuisson and Kline 2002). They com-
monly occur with trauma to multiple systems, so
that the concern for preservation of life or limb
may overshadow or obscure their presence
(Leffert 1974).
Fogarty and Brennen (2002) reviewed nine
patients (two open injuries) who underwent upper
root brachial plexus reconstruction with cable
grafting. One patient had neurotization (implantation of a nerve into a paralyzed muscle) in addition to grafting. Sixty-six percent (6/9) of patients
had a good outcome with return of elbow exion.
Patients with an open injury to the plexus had a
better prognosis than those with a closed injury.
Dubuisson and Kline (2002) reviewed a larger
series of 100 consecutive patients with brachial
plexus injuries (23 open). Emergency surgery for
vessel or nerve repair was necessary in 18 patients.
The surgical procedures performed included neurolysis alone in 12 patients, nerve grafting in 81,
end-to-end anastomosis in ve, and/or neurotization in 47 patients. Among the 18 patients with
open wounds, 14 (78%) recovered to a Grade 3
(contraction of proximal muscles against some
resistance and of distal muscles against at least
gravity) or better level, as did 35 (58%) of 60
patients with stretch injuries. In all cases of C5–
C6 stretch injuries repaired by nerve grafting
(n=10), the patients recovered useful arm function. The authors stressed the difculty posed by
these severe injuries and the value of cable grafting and neurotization in their management.
Trauma to the posterior cervical triangle may
involve the accessory nerve resulting in a “frozen
shoulder.” In a series of 13 patients with injury of
the accessory nerve (two with sharp glass injury),
Vastamäki and Solonen (1984) reported nine
operative procedures. In ve cases neurolysis, in
two cases neurorraphy, and in two cases reconstruction with a sural nerve graft were performed
3–17months post-injury. The result was good or
fair after six operative procedures (65%). In one
instance a good and in three others a fair recovery
was achieved without operation (follow-up time
20months).
Injury of the phrenic nerve results in diaphragmatic paresis. The resulting elevation of the ipsilateral hemidiaphragm is diagnosed on
postoperative chest radiography and may be conrmed by ultrasound or uoroscopy. Surgical
treatment is offered following a minimum of
6months of conservative management. Operative
planning is based on pre- and intraoperative testing using one or more established nerve reconstruction techniques (neurolysis, interpositional
grafting, or neurotization). Improvement in diaphragmatic function can follow after surgical
treatment as testied by pulmonary function testing, uoroscopic sniff testing, and a standardized
quality-of-life survey (Kaufman etal. 2011).
Injury to the recurrent nerve is a rare nding.
Larson and Cohn (1976) reviewed 30 cases of
laryngeal trauma (18 blunt, 12 penetrating
wounds) and identied unilateral recurrent nerve
injury in only one patient (3%). Bilateral recurrent laryngeal nerve injury has been reported in a
10-year-old girl who sustained a severe blunt
trauma to the neck with fracture of C2–C3 and
transection of trachea and esophagus (Davies
etal. 2001). In cases of a recognized injury, nerve
anastomosis should be the standard management.
Better phonation and perceptually rated voice
quality have been demonstrated in patients having had immediate direct laryngeal nerve anastomosis compared to those who did not undergo
repair (Hong et al. 2014). If a patient’s voice
quality and aspiration do not improve at 6months,
medialization laryngoplasty (Chou etal. 2003) or
laryngeal reinnervation using ansa cervicalis (Li
etal. 2014) can be considered.
10.7 Thyroid andSubmandibular
Gland Injuries
Thyroid gland injury due to blunt neck trauma is
uncommon. Delikoukos and Mantzos (2007)
reported an incidence of ca 2% (4/231 patients
References
Данная книга находится в списке для перевода на русский язык сайта https://meduniver.com/
113
with neck trauma). Von Ahnen et al. (2014)
reviewed the relevant publications in PubMed
and identied 34 reports on traumatic thyroid
rupture. Spencer etal. (2019) used the National
Trauma Data Bank (2007–2015) to identify
patients with thyroid injury and reported an incidence of 0.1%. Fifty-nine percent of patients had
isolated thyroid injury, and 40.3% had thyroid
and concomitant neck injury. Most of the reported
cases have involved rupture of a preexisting goitrous thyroid gland; however, rupture of a normal
thyroid has also been reported (Park etal. 2006;
Stunell etal. 2007).
Patients usually present with a painful, swollen neck or may even be asymptomatic at the
initial stage. However, the thyroid is an organ
very rich in blood supply; consequently, airway
obstruction can develop due to a large hematoma
and a pseudoaneurysm as a delayed complication (Park etal. 2006). The main concern of the
clinician is respiratory distress due to airway
obstruction. Laboratory examination shows the
elevated free T4 and T3 levels released from the
thyroid gland cell rupture. TSH can be initially
decreased by the negative feedback of the elevated thyroid hormones (Park et al. 2006).
Ultrasound and CT are used for the diagnosis of
thyroid rupture. Sonography, as a rst-line
method, evaluates gland rupture, extent of bleeding, and injury to adjacent vascular structures
(Park etal. 2006; Stunell etal. 2007). CT can be
implemented as a complement to sonography.
Conservative management has been suggested
for selected cases (Park etal. 2006; Stunell etal.
2007). Observation is necessary, however, in
order to check for progressive symptoms and
developing complications. When indicated, surgical management (repair, lobectomy, thyroidectomy) is pursued. Thyroid operative intervention
was rare with direct thyroid repair being the
most common type of surgical intervention performed (Spencer et al. 2019). Mortality was
decreased for patients with isolated thyroid
injury compared with thyroid and concomitant
neck injury (8.9% vs. 19%, p<0.001) (Spencer
etal. 2019).
Occasionally, patients can develop a thyroid
storm. They manifest fever, nervous system dis-
orders (confusion, stupor), tachycardia, tachypnea, hypertension, and gastrohepatic
dysfunction (nausea, vomiting, diarrhea, and/or
jaundice) (Vora et al. 2002; Wilkinson 2008;
Sabnis etal. 2011). Therapy is directed at stabilizing the patient by correcting the hyperthyroid
state and managing the systemic decompensation. One can then proceed with the surgical
treatment (Vora et al. 2002; Delikoukos and
Mantzos 2007). Although very uncommon, it
should be kept in mind that a potentially lifethreatening thyroid storm can be precipitated by
blunt neck trauma even in patients without
known hyperthyroidism.
Submandibular gland injury is a very rare
occurrence in cases of neck injuries. This is due
to protection from the mandibular body and only
penetrating trauma underneath the mandible,
trauma that fractures the mandible, or penetrating
injuries to the oor of the mouth can reach and
damage the gland (Liu et al. 2020). Glandular
trauma can lead to life-threatening airway compromise, and this possibility should be considered in patients presenting with acute pain and
fullness in the jaw and neck after trauma
(Harbison and Page 2010). Imaging diagnostics
depend on associated airway impediment, facial
fracture, or nerve palsy, as well as mechanism of
trauma. CT is preferred over MRI because of
availability, cost, and time to results (Liu et al.
2020). Injury to the gland will most likely cause
other pathologies identiable on CT imaging,
such as airway obstruction, vascular compromise, and fractures (Liu etal. 2020). Management
includes surgery (Harbison and Page 2010; Liu
etal. 2020). Surgical excision of the gland is via
a preexisting wound or a lateral surgical approach
in the context and timing of management of other
associated neck injuries.
References
Abujamra L, Joseph MM. Penetrating neck injuries in
children: a retrospective review. Pediatr Emerg Care.
2003;19:308–13.
von Ahnen T, von Ahnen M, Wirth V, et al. [Traumatic
thyroid rupture: case report and review of the litera-
ture]. Wien Med Wochenschr. 2014;164:239–44.
114
10 Injuries oftheNeck
Akhtar S, Awan S. Laryngotracheal trauma: its manage-
ment and sequelae. J Pak Med Assoc. 2008;58:241–3.
Anson BJ, McVay CB.The neck. In: Anson BJ, McVay
CB, editors. Surgical anatomy. Philadelphia, PA:
Saunders; 1971. p.239–313.
Armstrong WB, Detar TR, Stanley RB. Diagnosis
and management of external penetrating cervical esophageal injuries. Ann Otol Rhinol Laryngol.
1994;103:863–71.
Asensio JA, Berne J, Demetriades D, etal. Penetrating
esophageal injuries: time interval of safety for preoperative evaluation – how long is safe? J Trauma.
1997;43:319–24.
Asensio JA, Chahwan S, Forno W, et al. Penetrating
esophageal injuries: multicenter study of the American
Association for the surgery of trauma. J Trauma.
2001;50:289–96.
Bagheri SC, Khan HA, Ben RB.Penetrating neck injuries.
Oral Maxillofac Surg Clin N Am. 2008;20:393–414.
Ball CG, Wyrzykowski AD, Nicholas JM, et al. A
decade’s experience with balloon catheter tamponade
for the emergency control of hemorrhage. J Trauma.
2011;70:330–3.
Bent JP III, Silver JR, Porubsky ES. Acute laryngeal
trauma: a review of 77 patients. Otolrayngol Head
Neck Surg. 1993;109:441–9.
Bif WL, Moore EE, Ryu RK, etal. The unrecognized
epidemic of blunt carotid arterial injuries: early
diagnosis improves neurologic outcome. Ann Surg.
1998;228:462–70.
Bif WL, Moore EE, Offner PJ, etal. Blunt carotid arte-
rial injuries: implications of a new grading scale. J
Trauma. 1999a;47:848–53.
Bif WL, Moore EE, Offner PJ, etal. Therapeutic impli-
cations of a new grading scale in 100 blunt carotid
arterial injuries. J Trauma Inj Infect Crit Care.
1999b;46:201.
Bif WL, Ray CE Jr, Moore EE, etal. Treatment related
outcomes from blunt cerebrovascular injuries: importance of routine follow-up arteriography. Ann Surg.
2002;235:699–706.
Biousse V, D’Anglejan-Chatillon J, Touboul PT, et al.
Time course of symptoms in extracranial carotid
artery dissections. A series of 80 patients. Stroke.
1995;26:235–9.
Blitzer DN, Ottochian M, O’Connor JV, et al. Timing of
intervention may inuence outcomes in blunt injury
to the carotid artery. J Vasc Surg. 2020;71:1323–32.
Bodanapally UK, Shanmuganathan K, Dreizin D, et al.
Penetrating aerodigestive injuries in the neck: a proposed CT-aided modied selective management algorithm. Eur Radiol. 2016;26:2409–17.
Breeze J, Allanson-Bailey LS, Hunt NC, etal. Mortality
and morbidity from combat neck injury. J Trauma
Acute Care Surg. 2012;72:969–74.
Brennan JA, Meyers AD, Jafek BW. Penetrating neck
trauma: a 5-year review of the literature 1983 to 1988.
Am J Otolaryngol. 1990;11:191–7.
Bromberg WJ, Collier BC, Diebel LN, etal. Blunt cere-
brovascular injury practice management guidelines:
the Eastern Association for the Surgery of Trauma. J
Trauma. 2010;68:471–7.
Bryant AS, Cerfolio RJ.Esophageal trauma. Thorax Surg
Clin. 2007;17:63–72.
Burgess CA, Dale OT, Almeyda R, etal. An evidence based
review of the assessment and management of penetrat-
ing neck trauma. Clin Otolaryngol. 2012;37:44–52.
Burlew CC, Bif WL, Moore EE, etal. Blunt cerebrovas-
cular injuries: redening screening criteria in the era
of non-invasive diagnosis. J Trauma Acute Care Surg.
2012;72:330–5.
Catapano JS, Israr S, Whiting AC, etal. Management of
extracranial blunt cerebrovascular injuries: experience
with an aspirin-based approach. World Neurosurg.
2020;133:e385–90.
Cheng J, Cooper M, Tracy E.Clinical considerations for
blunt laryngotracheal trauma in children. J Pediatr
Surg. 2017;52:874–80.
Chou FF, Su CY, Jeng SF, etal. Neurorraphy of the recur-
rent laryngeal nerve. J Am Coll Surg. 2003;197:52–7.
Cohen JE, Gomori JM, Itshayek E, et al. Single-center
experience on endovascular reconstruction of trau-
matic internal carotid artery dissections. J Trauma
Acute Care Surg. 2012;72:216–21.
Colella JJ, Diamond DL.Blunt carotid injury: reassessing
the role of anticoagulation. Am Surg. 1996;62:212–7.
Cothren CC, Moore EE, Bif WL, etal. Anticoagulation
is the gold standard therapy for blunt carotid injuries
to reduce stroke rate. Arch Surg. 2004;139:540–5.
Cruvinet Neto J, Dedivitis RA. [Prognostic factors of
penetrating neck trauma]. Braz J Otorhinolaryngol.
2011;77:121–4.
Cussack GS, Jurkovich GJ, Luterman A.Laryngotracheal
trauma: a protocol approach to a rare injury.
Laryngoscope. 1986;96:660–5.
De Regloix SB, Baumont L, Daniel Y, et al. Comparison
of penetrating neck injury management in combat ver-
sus civilian trauma: a review of 55 cases. Mil Med.
2016;181:935–40.
Delikoukos S, Mantzos F.Thyroid storm induced by blunt
thyroid gland trauma. Ann Surg. 2007;73:1247–9.
Demetriades D, Theodorou D, Cornwell E, etal. Evaluation
of penetrating injuries of the neck: prospective study
of 223 patients. World J Surg. 1997;21:41–7.
Dolgin SR, Wykoff TW, Kumar NR, et al. Conservative
medical management of traumatic pharyngoesoph-
ageal perforations. Ann Otol Rhinol Laryngol.
1992;101:209–15.
Dray TG, Coltrera MD, Pinczower EF. Thyroid carti-
lage fracture repair in rabbits: comparing healing
with wire and miniplate xation. Laryngoscope.
1999;109:118–22.
Du Toit DF, Coolen D, Lambrechts A, etal. The endovas-
cular management of penetrating carotid artery inju-
ries: long-term follow-up. Eur J Vasc Endovasc Surg.
2009;38:267–72.
DuBose J, Recinos G, Teixeira PG, et al. Endovascular
stenting for the treatment of traumatic internal
carotid injuries: expanding experience. J Trauma.
2008;65:1561–6.
References
Данная книга находится в списке для перевода на русский язык сайта https://meduniver.com/
115
DuBose J, Savage SA, Fabian TC, et al. The American
Association for the surgery of trauma prospective
observational vascular injury treatment (PROOVIT)
registry: multicenter data on modern vascular injury
diagnosis, management and outcomes. J Trauma
Acute Care Surg. 2015;78:215–22.
Dubuisson AS, Kline DG.Brachial plexus injury: a sur-
vey of 100 consecutive cases from a single service.
Neurosurgery. 2002;51:673–82.
Feliciano DV.Penetrating cervical trauma: “Current con-
cepts in penetrating trauma” IATSIC Symposium,
International Surgical Society, Helsinki, Finland,
August 25-29, 2013. World J Surg. 2015;39:1363–72.
Feliciano DV, Bitondo CG, Mattox KL, et al.
Combined trachea-oesophageal injuries. Am J Surg.
1985;150:710–5.
Fogarty BJ, Brennen MD. Upper root brachial plexus
trauma; patient selection and reconstruction. Injury.
2002;33:57–62.
Forner D, Noel CW, Guttman MP, et al. Blunt versus
penetrating neck trauma: a retrospective cohort study.
Laryngoscope. 2021;131:E1109–16.
Fuhrman GM, Stieg FH III, Buerk CA.Blunt laryngeal
trauma: classication and management protocol. J
Trauma. 1990;30:87–92.
Gillespie DL. Comments regarding operative manage-
ment of penetrating carotid artery injuries. Eur J Vasc
Endovasc Surg. 2011;42:21.
Gonzalez RP, Falimirski M, Holevar MR, etal. Penetrating
zone II neck injury: does dynamic computed tomographic scan contribute to the diagnostic sensitivity of
physical examination for surgically signicant injury?
A prospective blinded study. J Trauma. 2003;54:64–5.
Goudy SL, Miller FB, Bumpous JM. Neck crepitance:
evaluation and management of suspected upper aerodigestive tract injury. Laryngoscope. 2002;112:791–5.
Grewal H, Rao PM, Mukerji S, et al. Management of
penetrating laryngotracheal injuries. Head Neck.
1995;17:494–502.
Hanna K, Douglas M, Asmar S, etal. Treatment of blunt
cerebrovascular injuries: anticoagulants or antiplatelet
agents? J Trauma Acute Care Surg. 2020;89:74–9.
Harbison JM, Page MP. Submandibular gland injury and
delayed airway compromise caused by a seat belt. Am
J Otolaryngol. 2010;31:209–11.
Hatzitheophilou C, Strahlendorf C, Kakoyiannis S, etal.
Penetrating external injuries of the oesophagus and
pharynx. Br J Surg. 1993;80:1147–9.
Herrera MA, Tintinago LF, Morales WV, et al. Damage
control of laryngotracheal trauma: the golden day.
Colomb Med (Cali). 2020;51:e4124599.
Hong JW, Roh TS, Yoo HS, et al. Outcome with imme-
diate direct anastomosis of recurrent laryngeal
nerves injured during thyroidectomy. Laryngoscope.
2014;124:1402–8.
Hundersmarck D, Reinders Folmer E, de Borst GJ,
et al. Penetrating neck injury in two Dutch level 1
trauma centres: the non-existent problem. Eur J Vasc
Endovasc Surg. 2019;58:455–62.
Ibraheem K, Wong S, Smith A, etal. Computed tomog-
raphy angiography in the “no-zone” approach era
for penetrating neck trauma: a systematic review. J
Trauma Acute Care Surg. 2020;89:1233–8.
Kaufman MR, Elkwood AI, Rose MI, etal. Reinnervation
of the paralyzed diaphragm: application of nerve sur-
gery techniques following unilateral phrenic nerve
injury. Chest. 2011;140:191–7.
Keszler P, Buzna E.Surgical and conservative management
of esophageal perforation. Chest. 1980;80:158–62.
Larson DL, Cohn AM.Management of acute laryngeal
injury: a critical review. J Trauma. 1976;16:858–62.
Lee TS, Ducic Y, Gordin E, etal. Management of carotid
artery trauma. Craniomaxillofac Trauma Reconstr.
2014;7:175–89.
Leffert RD. Brachial – plexus injuries. N Engl J Med.
1974;291:1059–67.
Li M, Chen S, Wang W, etal. Effect of duration of dener-
vation on outcomes of ansa-recurrent laryngeal nerve
reinnervation. Laryngoscope. 2014;124:1900–5.
Liu C, Darian A, Romeus L, etal. Submandibular gland
injury with a ball bearing gunshot wound. Cureus.
2020;12:e11268.
Low GM, Inaba K, Chouliaras K, etal. The use of the
anatomic “zones” of the neck in the assessment of
penetrating neck injury. Am Surg. 2014;80:970–4.
Lupetin AR, Hollander M, Rao VM. CT evaluation of
laryngotracheal trauma. Semin Musculoskelet Radiol.
1998;2:105–16.
Madani A, Pecorelli N, Razek T, et al. Civilian airway
trauma. A single-institution experience. World J Surg.
2016;40:2658–66.
Madiba TE, Muckart DJJ.Penetrating injuries to the cer-
vical oesophagus: is routine exploration mandatory?
Ann R Coll Surg Engl. 2003;85:162–6.
Madsen AS, Laing GL, Bruce JL, etal. An audit of pene-
trating neck injuries in a South African trauma service.
Injury. 2016a;47:64–9.
Madsen AS, Laing GL, Bruce JL, etal. A comparative
audit of gunshot wounds and stab wounds to the neck
in a South African metropolitan trauma service. Ann R
Coll Surg Engl. 2016b;98:488–95.
Madsen AS, Oosthuizen G, Laing GL, etal. The role of
computed tomography angiography in the detection of
aerodigestive tract injury following penetrating neck
injury. J Surg Res. 2016c;205:490–8.
Madsen AS, Kong VY, Oosthuizen GV, etal. Computed
tomography angiography is the denitive vascular
imaging modality for penetrating neck injury: a South
African Experience. Scand J Surg. 2018a;107:23–30.
Madsen AS, Oosthuizen GV, Bruce JL, et al. Selective
nonoperative management of pharyngoesophageal
injuries secondary to penetrating neck trauma: a
single- center review of 86 cases. J Trauma Acute Care
Surg. 2018b;85:541–8.
Madsen AS, Bruce JL, Oosthuizen GV, etal. Correlation
between the level of the external wound and the inter-
nal injury in penetrating neck injury does not favour
an initial zonal management approach. BJS Open.
2020;4:704–13.
116
10 Injuries oftheNeck
McCormick ME, Fissenden TM, Chun RH.Resource uti-
lization and national demographics of laryngotracheal
trauma in children. JAMA Otolaryngol Head Neck
Surg. 2014;140:829–32.
Meisel RH, Hom DB.Penetrating trauma to the neck. In:
Cummings CW, Fredrickson JM, Harker LA, et al.,
editors. Otolaryngology head & neck surgery. St.
Louis, MO: Mosby; 1998. p.1707–20.
de Mello-Filho FV, Carrau RL.The management of laryn-
geal fractures using internal xation. Laryngoscope.
2000;110:2143–6.
Merritt RM, Bent JP, Porubsky ES. Acute laryngeal
trauma in the pediatric patient. Ann Otol Rhinol
Laryngol. 1998;107:104–6.
Mohlala ML, Ramaroko SP, Ramasodi KP, etal. A techni-
cal approach to tracheal and oesophageal injuries. S
Afr J Surg. 1994;32:114–6.
Monson DO, Saletta JD, Freeark RJ. Carotid vertebral
trauma. J Trauma. 1969;9:987–99.
Mutabagani KH, Beaver BL, Cooney DR, etal. Penetrating
neck trauma in children: a reappraisal. J Pediatr Surg.
1995;30:341–4.
Nason RW, Assuras GN, Gray PR, et al. Penetrating
neck injuries: analysis of experience from a Canadian
trauma centre. Can J Surg. 2001;44:122–6.
Navsaria PH, Omoshoro-Jones J, Nicol A. An analysis of
32 surgically managed penetrating carotid artery injuries. Eur J vasc Endovasc Surg. 2002;24:349–55.
Ngakane H, Muckart DJJ, Luvuno FM.Penetrating vis-
ceral injuries of the neck: results of a conservative
management policy. Br J Surg. 1990;77:908–10.
O’Banion LA, Dirks RC, Siada SS, etal. Risk factors for
stroke in penetrating carotid trauma– an analysis from
the PROOVIT Registry. J Trauma Acute Care Surg.
2022;92:717.
O’Neill JP, Shine N, Timon C.Complete traumatic laryn-
gotracheal separation. Ir Med J. 2009;102:291–2.
Ofah C, Hall E.Imaging assessment of penetrating injury
of the neck and face. Insights Imag. 2012;3:419–31.
Paladino L, Baron BJ, Shan G, etal. Computed tomogra-
phy angiography for aerodigestive injuries in penetrating neck trauma: a systematic review. Acad Emerg
Med. 2021;28:1160–72.
Park CH, Oh KK, Kim EK, et al. Thyroid gland rup-
ture after blunt cervical trauma. J Ultrasound Med.
2006;25:943–6.
Patterson BO, Holt PJ, Cleanthis M, etal. Imaging vascu-
lar trauma. Br J Surg. 2012;99:494–505.
Pham MH, Rahme RJ, Arnaout O, et al. Endovascular
stenting of extracranial carotid and vertebral artery
dissections: a systematic review of the literature.
Neurosurgery. 2011;68:856–66.
Raff LA, Schinnerer EA, Maine RG, etal. Contemporary
management of traumatic cervical and thoracic esophageal perforation: the results of an Eastern Association
for the Surgery of Trauma multi-institutional study. J
Trauma Acute Care Surg. 2020;89:691–7.
Ramadan F, Rutledge R, Oller D, et al. Carotid artery
trauma: a review of contemporary trauma center experiences. J Vasc Surg. 1995;21:46–55.
Randall DR, Rudmik LR, Ball CG, etal. External laryn-
gotracheal trauma: incidence, airway control, and
outcomes in a large Canadian center. Laryngoscope.
2014;124:E123–33.
Rao PM, Bhatti MF, Gaudino J, et al. Penetrating inju-
ries of the neck: criteria for exploration. J Trauma.
1983;23:47–9.
Reeve NH, Kim Y, Kahane JB, et al. Management of
traumatic laryngotracheal separation: case series and
review. J Trauma Acute Care Surg. 2021;90:e132–7.
Reva VA, Pronchenko AA, Samokhalov IM. Operative
management of penetrating carotid artery injuries. Eur
J Vasc Endovasc Surg. 2011;42:16–20.
Rieth A, Varga E, Kovács T, etal. Contemporary man-
agement strategies of blunt tracheobronchial injuries.
Injury. 2021;52(Suppl 1):S7–S14.
Roon AJ, Christiansen N.Evaluation and treatment of pen-
etrating cervical injuries. J Trauma. 1979;19:391–7.
Sabnis GR, Karnik ND, Chavan SA, etal. Trauma pre-
cipitating thyroid storm. J Assoc Physicians India.
2011;59:117–9.
Schaefer SD. Management of acute blunt and pen-
etrating external laryngeal trauma. Laryngoscope.
2014;124:233–44.
Scheid R, Zimmer C, Schroeter ML, et al. The clinical
spectrum of blunt cerebrovascular injury. Neurologist.
2006;12:255–62.
Scott WW, Sharp S, Figueroa SA, etal. Clinical and radio-
graphic outcomes following traumatic Grade 1 and 2
carotid artery injuries: a 10-year retrospective analysis
from a Level I trauma center. The Parkland Carotid
and Vertebral Artery Injury Survey. J Neurosurg.
2015a;122:1196–201.
Scott WW, Sharp S, Figueroa SA, etal. Clinical and radio-
graphic outcomes following traumatic Grade 3 and 4
carotid artery injuries: a 10-year retrospective analysis
from a Level 1 trauma center. The Parkland Carotid
and Vertebral Artery Injury Survey. J Neurosurg.
2015b;122:610–5.
Scriba MF, Navsaria PH, Nicol AJ, etal. Foley-catheter
balloon tamponade (FCBT) for penetrating neck inju-
ries (PNI) at Groote Schuur Hospital: an update. S Afr
J Surg. 2017;55:64.
Shilston J, Evans DL, Simons A, et al. Initial man-
agement of blunt and penetrating neck trauma.
BJA Educ. 2021;21:329. https://doi.org/10.1016/j.
bjae.2021.04.002.
Shiroff AM, Gale SC, Martin ND, et al. Penetrating
neck trauma: a review of management strategies and
discussion of the “No Zone” approach. Am Surg.
2013;79:23–9.
Shuker ST.Expanding hematoma’s life-threatening neck
and face emergency management of ballistic injuries.
J Craniofac Surg. 2016;27:1282–5.
Simmons JD, Ahmed N, Donnellan KA, et al.
Management of traumatic vascular injuries to the
neck: a 7-year experience at a Level I trauma center.
Am Surg. 2012;78:335–8.
Simpson C, Tucker H, Hudson A. Pre-hospital manage-
ment of penetrating neck injuries: a scoping review of
References
Данная книга находится в списке для перевода на русский язык сайта https://meduniver.com/
117
current evidence and guidance. Scan J Trauma Resusc
Emerg Med. 2021;29:137.
Spencer D, Grigorian A, Schubl S, etal. Thyroid trauma–
a national analysis of incidence, mortality, and concomitant injury. J Surg Res. 2019;242:200–6.
Ssenyonga PK, Le Feuvre D, Taylor A. Head and neck
neurovascular trauma: clinical and angiographic correlation. Interv Neuroradiol. 2015;21:108–13.
Stanley RB Jr, Armstrong WB, Fetterman BL, et al.
Management of external penetrating injuries into
the hypopharyngeal-cervical esophageal funnel. J
Trauma. 1997;42:675–9.
Stone HH, Callahan GS.Soft tissue injuries of the neck.
Surg Gynecol Obstet. 1963;117:745–52.
Stunell H, Obrien J, Benfayed W, et al. Thyroid gland
rupture after blunt cervical trauma. J Ultrasound Med.
2007;26:992.
Tallon JM, Ahmed JM, Sealy B.Airway management in
penetrating neck trauma at a Canadian tertiary trauma
center. CJEM. 2007;9:101–4.
Tatum JM, Barmparas G, Dhillon NK, etal. Penetrating
pharyngoesophageal injury: practice patterns in the
era of nonoperative management- a national trauma
data bank review from 2007 to 2011. J Investig Surg.
2019;21:1–8.
Tessler RA, Nguyen H, Newton C, et al. Pediatric pen-
etrating neck trauma: hard signs of injury and selective neck exploration. J Trauma Acute Care Surg.
2017;82:989–94.
Texeira F, Menegozzo CA, Netto SD, etal. Safety in selec-
tive surgical exploration in penetrating neck trauma.
World J Emerg Surg. 2016;11:32.
Thoma M, Navsaria PH, Edu S, et al. Analysis of 203
patients with penetrating neck injuries. World J Surg.
2008;32:2716–23.
Triggiani E, Belsey R. Oesophageal trauma: incidence,
diagnosis and management. Thorax. 1977;32:241–9.
Trone TH, Schaefer SD.Blunt and penetrating laryngeal
trauma: a 13-year review. Otolaryngol Head Neck
Surg. 1980;88:257–61.
Van Waes OJ, Cheriex KC, Navsaria PH, et al.
Management of penetrating neck injuries. Br J Surg.
2012;99(Suppl 1):1749–54.
Varghese A.Penetrating neck injury: a case report and
review of management. Indian J Surg. 2013;75:43–6.
Vassiliu P, Baker J, Henderson S, etal. Aerodigestive inju-
ries of the neck. Am Surg. 2001;67:75–9.
Vastamäki M, Solonen KA.Accessory nerve injury. Acta
Orthop Scand. 1984;55:296–9.
Verschueren DS, Bell RB, Bagheri SC, etal. Management
of laryngo-tracheal injuries associated with cra-
niomaxillofacial trauma. J Oral Maxillofac Surg.
2006;64:203–14.
Vick LR, Islam S.Adding insult to injury: neck explora-
tion for penetrating pediatric neck trauma. Am Surg.
2008;74:1104–6.
Vora NM, Fedok F, Stack BC Jr. Report of a rare case
of trauma-induced thyroid storm. Ear Nose Throat J.
2002;81:570–2.
Wahl WL, Brandt MM, Thompson BG, etal. Antiplatelet
therapy: an alternative to heparin for blunt carotid
injury. J Trauma. 2002;52:896–901.
Wang AA, Feng AL, Rao V, etal. Clinical, radiologic, and
endolaryngeal ndings in laryngeal fractures: a 15-year
case series. OTO Open. 2022;6:2473974X221080164.
https://doi.org/10.1177/2473974X221080164.
Wilkinson JN. Thyroid storm in a polytrauma patient.
Anaesthesia. 2008;63:1001–5.
Xu AA, Breeze JL, Paulus JK, et al. Epidemiology of
Traumatic esophageal injury: an analysis of the
National Trauma Data Bank. Am Surg. 2019;85:342–9.
Соседние файлы в папке Библиотека им академика М.И. Перельмана