Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-11-24T09:07:19.292Z Has data issue: false hasContentIssue false
  • English
  • Français

Blunt neck trauma at a level I trauma centre: six-year retrospective case note review

Published online by Cambridge University Press:  14 October 2019

B A Zakaria ,
J Muzaffar ,
L E Orr ,
C J Coulson  and
N Sharma
B A Zakaria
Affiliation:
College of Medical and Dental Sciences, University of Birmingham, UK
J Muzaffar
Affiliation:
Department of Clinical Neurosciences, University of Cambridge, UK Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, University Hospitals Birmingham, UK Department of Otolaryngology, University Hospitals Birmingham, UK
L E Orr
Affiliation:
Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, University Hospitals Birmingham, UK Department of Otolaryngology, University Hospitals Birmingham, UK
C J Coulson
Affiliation:
Department of Otolaryngology, University Hospitals Birmingham, UK
N Sharma*
Affiliation:
Institute of Head and Neck Studies and Education, College of Medical and Dental Sciences, University of Birmingham, UK Department of Otolaryngology, University Hospitals Birmingham, UK
*
Author for correspondence: Dr N Sharma, Institute of Head and Neck Studies and Education, 2nd Floor, Robert Aitkin Building, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, UK E-mail: [email protected] Fax: +44 121 414 8046
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Blunt neck trauma can cause serious morbidity and mortality rates of up to 40 per cent, but there is a paucity of literature on the topic.

Method

A retrospective case note review was performed for all blunt neck trauma cases managed at the Queen Elizabeth Hospital Birmingham between 1st January 2011 and 31st December 2017.

Results

Seventeen cases were managed, with no mortality and limited morbidity. Most patients were male (70.6 per cent) and road traffic accidents were the most common cause of injury (41.2 per cent). The median age of patients was 40.6 years (range, 21.5–70.3 years). Multidetector computed tomography angiography of the neck was performed in 9 patients (52.9 per cent) with ‘hot’ reports made by on-duty radiology staff matching consultant reports in all but 1 case. Six patients underwent operative exploration yielding a negative exploration rate of 33.3 per cent. Imaging reports matched operative findings in 3 cases (60 per cent).

Conclusion

Blunt neck trauma is uncommon but usually presents in polytrauma. Imaging has inaccuracies when compared with operative findings, regardless of radiological experience.

Keywords

Neck Injuries
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 133 , Issue 11 , November 2019 , pp. 943 - 947
Copyright
Copyright © JLO (1984) Limited, 2019 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Dr N Sharma takes responsibility for the integrity of the content of the paper

Presented at the British Academic Conference in Otolaryngology, 4–6th July 2018, Manchester, UK.

References

1Souba, WW, Fink, MP, Jurkovich, GJ, Kaiser, LP, Pearce, WH, Pemberton, JH et al. ACS Surgery: Principles and Practice, 6th edn. New York: Web MD, 2006Google Scholar
2Comer, BT, Gal, TJ. Recognition and management of the spectrum of acute laryngeal trauma. J Emerg Med 2012;43:289–93Google Scholar
3Thevasagayam, MS, Pracy, P. Laryngeal trauma: a systematic approach to management. J Trauma 2005;7:87–94Google Scholar
4Paluska, SA, Lansford, CD. Laryngeal trauma in sport. Curr Sports Med Rep 2008;7:16–21Google Scholar
5Brennan, JA. Otolaryngology/Head and Neck Surgery Combat Casualty Care in Operation Iraqi Freedom and Operation Enduring Freedom 2015. Washington: Borden Institute, 2015Google Scholar
6Mendis, D, Anderson, JA. Blunt laryngeal trauma secondary to sporting injuries. J Laryngol Otol 2017;131:728–35Google Scholar
7Jalisi, S, Zoccoli, M. Management of laryngeal fractures – a 10-year experience. J Voice 2011;25:473–9Google Scholar
8Atkins, BZ, Abbate, S, Fisher, SR, Vaslef, SN. Current management of laryngotracheal trauma: case report and literature review. J Trauma 2004;56:185–90Google Scholar
9Butler, AP, Wood, BP, O'Rourke, AK, Porubsky, ES. Acute external laryngeal trauma: experience with 112 patients. Ann Otol Rhinol Laryngol 2005;114:361–8Google Scholar
10Schaefer, SD. Management of acute blunt and penetrating external laryngeal trauma. Laryngoscope 2014;124:233–44Google Scholar
11Leopold, DA. Laryngeal trauma: a historical comparison of treatment methods. Arch Otolaryngol 1983;109:106–11Google Scholar
12Chokshi, FH, Munera, F, Rivas, LA, Henry, RP, Quencer, RM. 64-MDCT angiography of blunt vascular injuries of the neck. Am J Roentgenol 2011;196:309–15Google Scholar
13Biffl, WL, Moore, EE, Ryu, RK, Offner, PJ, Novak, Z, Coldwell, D et al. The unrecognized epidemic of blunt carotid arterial injuries: early diagnosis improves neurological outcome. Ann Surg 1998;228:462–70Google Scholar
14Bromberg, WJ, Collier, BC, Diebel, LN, Dwyer, KM, Holevar, MR, Jacobs, DG et al. Blunt cerebrovascular injury. J Trauma 2010;68:471–7Google Scholar
15deSouza, RM, Crocker, MJ, Haliasos, N, Rennie, A, Saxena, A. Blunt traumatic vertebral artery injury: a clinical review. Eur Spine J 2011;20:1405–16Google Scholar
16Eastman, AL, Chason, DP, Perez, CL, McAnulty, AL, Minei, JP. Computed tomographic angiography for the diagnosis of blunt cervical vascular injury: is it ready for primetime? J Trauma 2006;60:925–9Google Scholar
17Biffl, WL, Moore, EE, Offner, PJ, Brega, KE, Franciose, RJ, Burch, JM. Blunt carotid arterial injuries: implications of a new grading scale. J Trauma 1999;47:845–53Google Scholar
18Office for National Statistics. Census 2011 West Midlands usual resident population. In: https://www.ons.gov.uk/census/2011census/2011censusdata/2011censusdatacatalogue [12 November 2018]Google Scholar