A Clinicoradiological Study of Neck Injuries and Their Management

Abstract

AIMS AND OBJECTIVES: 1. To study the incidence of various neck injuries in patients attending ENT OPD/admitted in ENT ward. 2. To evaluate the distribution in age, sex, modes of presentation and nature of injury (suicidal, homicidal or accidental) 3. To categorize neck injuries according to zones of involvement. 4. To study cases of neck injuries where tracheostomy was needed/blood transfusion was required. TYPE OF STUDY: A prospective clinical study. MATERIALS AND METHODS: Patients admitted in ENT WARD/attending ENT OPD, GMCH, Guwahati with neck injuries are selected for the present study. A prospective study is conducted over the selected group for their age, sex, modes of presentation and their investigations. Patients requiring tracheostomy in neck injuries are also included. Study on various treatment modalities either conservative or surgical is done. OBSERVATION AND RESULTS: The neck injuries were more common in males and in most of the cases belonged to lower socioeconomic status. Homicidal intent was most common with edged weapon as the choice. Penetrating wound was seen to be most common type. Commonest mode of presentation was bleeding. The most common investigation done was blood grouping and hemoglobin. In maximum cases, repair of soft tissue was done. Morbidity with left vocal cord paresis in l case and facial palsy in l case were observed. Mortality in our study was 1.31%. CONCLUSION: The increase in incidence of neck injuries is due to urban violence, psychological stress or illness and accidents. Open neck injury was more common than close injury. While managing the cases we found that clinical examination is more important than any other investigation. Management of neck injuries requires multidisciplinary approach. Consultations were taken from the department of CTVS, Psychiatry, Neurology and other departments as per requirement.

Demographic, Etiological, and Clinical Characteristics of Eyelid Lacerations

“…Consistent with other studies, our results showed that EL are more common in men, with a ratio of 3.9:1. 2 , 3 In a publication conducted in Türkiye, similar to our results, the reported ratio was 3.75:1. 7 This may be related to the more frequent participation of men in activities that can increase the risk of eye injury, such as occupational or industrial activities (construction, manufacturing), sports or recreational activities (contact sports, shooting, hunting), and certain hobbies (woodworking, metalworking).…”

“…Similar to our results, the most commonly reported late complication of EL is lid notching, which usually results from improper approximation or development of a wound gap. 9 Kumar and Batham 3 also reported lid notching (6.3%), hypertrophic scars (1.8%), ptosis (2.7%), tearing (2.7%), and lagophthalmos (0.9%) as other complications. Most complications can be prevented through careful and effective primary closure.…”

“…In another study conducted in India, 59.9% of EL were caused by road accidents, followed by assault (13.6%), animal attacks (12.7%), and falls (9%). 3 …”

“…The incidence of accompanying ocular injuries has been reported as 17-24% in various studies. Kumar and Batham 3 reported that the most common accompanying finding was subconjunctival hemorrhage, followed by hyphema, conjunctival laceration, traumatic lens injury, and corneal laceration. Tabatabaei et al 10 reported that globe injury was present in 6.1% of the cases.…”

“…Eyelid lacerations (EL) present with various findings, such as partial- or full-thickness lid defects, canalicular damage, and accompanying ocular damage. 3 , 4 If not promptly and appropriately treated, these injuries can result in serious anatomic and functional problems, including lid deformities, ocular surface disorders, and associated ocular damage. 5 Incomplete or inadequate repair of the eyelids may lead to complications such as entropion, ectropion, trichiasis, and epiphora, significantly affecting the patient’s quality of life.…”