Defining Zone I of penetrating neck trauma

Rodríguez-Luna, María Rita; Guarneros-Zárate, Joaquín E.; Hernández-Méndez, José Roberto; Tueme-Izaguirre, Jorge; Noriega-Usi, Victor Manuel; Fenig-Rodríguez, José

doi:10.1097/ta.0000000000000978

Cited by 6 publications

(2 citation statements)

References 25 publications

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“…This made surgical access to the severed artery particularly difficult. Moreover, the numerous anastomoses between the branches of the two ECAs and their neighboring arteries made complete hemorrhage control using proximal arterial clamping impossible [ 16 , 29 , 48 ].…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, clinicians in most centers report limited experience with handling similar cases, which, in turn, causes considerable anxiety in medical personnel [ 7 , 15 ]. Finally, because these cases are rare, scarce information regarding the surgical anatomy of these wounds is available [ 16 ]. The aim of the presentation of this clinical case, as well as of an anatomical dissection study performed to explain the clinical findings observed, is to add to the scant literature on emergent lesions to the ECA and the FN.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Stab injury to the preauricular region with laceration of the external carotid artery without involvement of the facial nerve: a case report

Casal¹,

Pelliccia²,

Pais³

et al. 2017

J Med Case Reports

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BackgroundOpen injuries to the face involving the external carotid artery are uncommon. These injuries are normally associated with laceration of the facial nerve because this nerve is more superficial than the external carotid artery. Hence, external carotid artery lesions are usually associated with facial nerve dysfunction. We present an unusual case report in which the patient had an injury to this artery with no facial nerve compromise.Case presentationA 25-year-old Portuguese man sustained a stab wound injury to his right preauricular region with a broken glass. Immediate profuse bleeding ensued. Provisory tamponade of the wound was achieved at the place of aggression by two off-duty doctors. He was initially transferred to a district hospital, where a large arterial bleeding was observed and a temporary compressive dressing was applied. Subsequently, the patient was transferred to a tertiary hospital. At admission in the emergency room, he presented a pulsating lesion in the right preauricular region and slight weakness in the territory of the inferior buccal branch of the facial nerve. The physical examination suggested an arterial lesion superficial to the facial nerve. However, in the operating theater, a section of the posterior and lateral flanks of the external carotid artery inside the parotid gland was identified. No lesion of the facial nerve was observed, and the external carotid artery was repaired. To better understand the anatomical rationale of this uncommon clinical case, we dissected the preauricular region of six cadavers previously injected with colored latex solutions in the vascular system. A small triangular space between the two main branches of division of the facial nerve in which the external carotid artery was not covered by the facial nerve was observed bilaterally in all cases.ConclusionsThis clinical case illustrates that, in a preauricular wound, the external carotid artery can be injured without facial nerve damage. However, no similar description was found in the reviewed literature, which suggests that this must be a very rare occurrence. According to the dissection study performed, this is due to the existence of a triangular space between the cervicofacial and temporofacial nerve trunks in which the external carotid artery is not covered by the facial nerve or its branches.

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Section: Discussionmentioning

confidence: 99%