Computed Tomographic Scan Can Be Used for Surgical Decision Making in Zone II Penetrating Neck Injuries

Abstract

This small prospective study demonstrates that zone II penetrating neck injuries can be accurately evaluated by CT scan. In addition, the CT scan can be used for surgical decision making. This will eliminate the need for mandatory exploration and limit the role of angiography, esophagography, and endoscopy in zone II penetrating neck injuries.

Current Management of Laryngotracheal Trauma: CASE-REPORT and Literature Review

“…The information gained by CT scanning thus allows more informed decisions regarding management, particularly when nonoperative treatment is considered, by helping to exclude injuries of the laryngeal framework that require operative intervention. 35 However, CT scanning cannot be recommended as a replacement for "triple endoscopy" in penetrating cervical trauma, when esophageal, airway, and vascular injuries must all be excluded. 18 Nonoperative management of LT trauma assumes the airway is stable and is protected by the patients' own reflexes or by an endotracheal tube.…”

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

“…The choice of imaging modalities for the evaluation of stable patients with PNIs remains a source of debate. 1,4,[13][14][15][16][17][18] Stable zone II injuries may be evaluated with plain radiography, conventional angiography, CT (conventional, spiral, multidetector helical computed tomographic angiography [CTA]), duplex ultrasonography, endoscopy, or laryngoscopy/ bronchoscopy depending on the nature of suspected injuries. 2,17 In reviewing the literature on this topic, we focused on imaging modalities used to rule out significant life-threatening injury attributable to occult vascular injury.…”

“…Although useful for detecting metallic foreign bodies and extraluminal air, plain films are not overly helpful in detecting injuries to deeper structures. 10,13,18 2. Historically, angiography has been considered the gold standard for diagnosis of vascular injuries in PNIs.…”

Thoracic and neck trauma. Part four

“…Patients with stab wounds to zone II who are asymptomatic and show no signs of injury on their physical examination may be observed clinically without the need for obtaining further studies (Atteberry et al, 1994). Those who do exhibit signs or symptoms after stab wounds to zone II should undergo further radiologic investigation, beginning usually with a CT scan and, if indicated based on scan results, oesophagoscopy, bronchoscopy or angiography (Gonzalez et al, 2003;Mazolewski et al, 2001).…”