Emergency Management of Cut Throat Injury: A Report of 2 Cases.

Abstract

BACKGROUND Cut throat injury (CTI) is a type of penetrating neck injury that is an emergency in otorhinolaryngology and head and neck surgery. CASE REPORT We report 2 cases of CTI in zone 2. Patient 1 had severe injury to the larynx, trachea, and esophagus due to attempted suicide, whereas Patient 2 had a ruptured larynx due to attempted homicide, without injury to the vocal cords. The emergency doctor only used gauze to compress the neck rather than inserting a tracheal cannula through the opening immediately to maintain airway patency. Patient 1 had dyspnea at 1 point. Fortunately, Patient 2 had a stable neck wound did not bleed much, with few blocking blood clots. After performing a low tracheotomy in these 2 patients, the neck injury was repaired, gastric tubes were placed, and gastric enteral feeding diet was commenced. Both patients received anti-infection treatment and professional psychiatric therapy after surgery, and both recovered well. CONCLUSIONS Airway management is the critical first step, and the tracheal cannula should be inserted through the opening in the injured larynx for the first time to maintain airway patency; patients whose condition is unstable should undergo immediate surgical exploration, and those whose condition is stable without hard signs should undergo enhanced neck CT to assess the injury; prompt psychiatric care is also critical.