García-Zornoza Roberto, Morales-Angulo Carmelo, González-Aguado Rocío, Acle Cervera Leticia, Cortizo Vázquez Eloy, Obeso Agüera Sergio
Servicio de Otorrinolaringología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, España.
Acta Otorrinolaringol Esp. 2012 Jan-Feb;63(1):47-54. doi: 10.1016/j.otorri.2011.07.003. Epub 2011 Oct 19.
Neck injuries are of great clinical interest because they can induce very significant consequences if not handled properly and can even lead to death. The aim of our study was to analyse external deep cervical trauma in our hospital.
A retrospective study of all external deep neck injuries seen in a tertiary hospital over the course of 24 years that involved changes in structures related to otolaryngology.
Twenty patients were included in our study. From all the injuries, 45% were secondary to traffic accidents, 27% from assault with a knife and 23% from attempted suicide. The injuries were open in 15 (68%) cases and closed in 7 (32%). The most common symptom was bleeding (55%), followed by respiratory disorders (23%). On examination, the most frequent sign was the appearance of subcutaneous emphysema (27%). Only 50% of patients underwent imaging before treatment, most often a neck CT (27%). 59% of patients needed surgery, with 6 patients (27%) requiring a tracheotomy. Two of them died (9%) and 6 suffered permanent complications.
Cervical injuries involving ENT structures are rare in our environment, with the most common cause being traffic accidents. It is important to have standardised guidelines for the management of these patients, because they can often developed severe complications or even die if not treated properly very rapidly.
颈部损伤具有重大临床意义,因为若处理不当可能引发极为严重的后果,甚至导致死亡。我们研究的目的是分析我院的颈部深部外伤情况。
对一家三级医院24年间所见到的所有涉及耳鼻喉科相关结构变化的颈部深部外伤进行回顾性研究。
我们的研究纳入了20例患者。在所有损伤中,45%继发于交通事故,27%因刀伤,23%因自杀未遂。15例(68%)损伤为开放性,7例(32%)为闭合性。最常见的症状是出血(55%),其次是呼吸障碍(23%)。检查时,最常见的体征是皮下气肿(27%)。仅50%的患者在治疗前接受了影像学检查,最常做的是颈部CT(27%)。59%的患者需要手术,6例(27%)需要气管切开术。其中2例死亡(9%),6例出现永久性并发症。
在我们的环境中,涉及耳鼻喉科结构的颈部损伤较为罕见,最常见的原因是交通事故。为这些患者制定标准化的管理指南很重要,因为如果不能迅速正确治疗,他们常常会出现严重并发症甚至死亡。