Soft tissue neck injuries

Abstract

The management of neck injuries differs with penetrating versus blunt and is highly dependent on the haemodynamic and physiological status of the patient. 1 Traditionally our practice guidelines for penetrating injuries were firmly directed if platysma was breached, with the only variability being time to intervention based upon the anatomic level or ‘zone’ of injury. Today, the dogma of mandatory exploration, especially in Zone II, is being challenged as greater clinical experience and new imaging capabilities evolve. 2 Blunt trauma composes only about 5% of all neck trauma with the most common injuries being contusions, muscle strains and ligamentous sprains. In both mechanisms of trauma, those injuries that become life threatening or have significant morbidity or mortality involve the airway, aerodigestive tract, vascular structures and/or nerves. By following the sound principles of Advanced Trauma Life Support (ATLS), the obvious threats are noted and addressed quickly. However, those that are subtle can be missed, have insidious onsets and are often only discovered at a severely deteriorated clinical state or at post-mortem. 1