Cervical trauma: Epidemiological, Diagnostic and Therapeutic aspects at the Adolphe SICE General Hospital in Pointe-Noire

Abstract

Introduction: Cervical spine injuries are relatively rare, and caused by external sharp and vulnating agents. They can be potentially serious and life-threatening. The aim of this work was to describe the epidemiological, clinical and therapeutic aspects. Patients and Method: This was a descriptive, retrospective, cross-sectional study of the records of patients with neck trauma from January 1, 2005 to December 31, 2018, conducted in the ENT and Cervico-Facial Surgery Department of the Adolphe SICE Hospital in Pointe-Noire (Congo-Brazzaville). Results: The study included 30 patients from a total of 107 cases of cervicofacial trauma. The average annual incidence of cervical trauma was 2 cases per year, with a predominance of males, including 25 males (83.3%) and 5 females (16.6%), i.e. a sex ratio of 5:1. The average age was 34.4 years with extremes of 17 to 70 years. 50% of our patients were single. The circumstances of occurrence were represented by knives (83% of cases), followed by road traffic injuries (13%) and firearms (3%). Sharp objects were the most common cause of injury (83%). The mechanism of injury was a section in 87% and a contusion in 13%. Neck pain was the main symptom in 100% of cases. The wound represented 87% of the physical examination, followed by edema and hemorrhage in 33% and 20% respectively. The trauma was isolated in 80% of cases and in a context of polytrauma in 4%. Exploratory and reparative cervicotomy was the most common surgical procedure, 87%, followed by tracheotomy, 27%. The evolution was simple, in spite of the parietal suppuration noted in 10% of the cases. Conclusion: Despite their rarity, cervical trauma remains a worrying surgical emergency in our work context. These traumas are the prerogative of young adult males in connection with external vulnating agents with high traumatic risk. Keywords: Trauma ; penetrating wound; Neck; Cervicotomy