Throat Injuries Research Articles

Severe Cut Throat Injury in a Child: A Case Report and Review of Literature

Severe Cut Throat Injury in a Child: A Case Report and Review of Literature

Alcohol Withdrawal Presenting with Cut Throat Injury during COVID-19 Lockdown: Case Reports from Nepal

Background. The relationship between alcohol dependence and suicidal tendency is well recognized. Self-harm by cut throat is an uncommon but is potentially life-threatening when attempted. We present a description and discussion of a series of three cases of alcohol dependence syndrome who presented with self-inflicted cut throat wounds during the lockdown period from 24th March to 7th July 2020 due to the COVID-19 pandemic at the largest tertiary care hospital in Nepal. Case description. During the three and a half months of COVID-19 lockdown, we had three cases of alcohol dependence syndrome presenting to emergency services with a self-inflicted cut throat injury. Two cases were diagnosed as having alcohol withdrawal delirium and one case as alcohol-induced psychotic disorder (alcoholic hallucinosis) as per the international classification of mental and behavioral disorders diagnostic criteria for research. All three cases were alcohol dependent for more than a decade, but with no prior self-harm attempts. Necessary surgical interventions were done by the Department of Otorhinolaryngology, and in liaison with the Department of Psychiatry, appropriate psychiatric management was done. All three cases had uneventful outcomes in regard to wound care and mental disorder. Conclusion. Suicidal precautions should be taken in alcohol dependence during phases of consumption and abstinence. Screening for alcohol dependence and withdrawal should be a standard process in all self-harm cases that present to the emergency department during a crisis.

Our experience of cut throat injury at a tertiary care center during COVID-19 pandemic

Background: Cut throat injury is a least commonly attempted method of suicide or homicide. Neck injury may be suicidal, homicidal or accidental depending upon the etiology. Hesitation mark around the wound is favor of suicidal attempt and without hesitation mark is a rare possibility of suicidal attempt. Methods: This is a retrospective study carried out over period of one year, between April 2020 to March 2021, in a tertiary care center of north central India, during Covid-19 pandemic before the second wave. Results: Total 37 cases were attended; incidence was more common in male than female (34:3). Most commonly involved age group was 21 to 30 years, most of the patients belonged to rural background and manual workers. Homicide was the most common cause of injury and mostly under the influence of alcohol. Conclusions: Young males belonging to lower socioeconomic status and rural background were most common victims of cut throat injury in our study, homicide being the most common causative factor. Life of the patients can be saved with less morbidity and mortality by the means of good triage management and early intervention.

Suicide by sharp force associated with major self-mutilation and self-cannibalism.

Self-stabbing and self-cutting represents an uncommon method of suicide. We present a case of a 30-year-old man who was found dead in the forest. The body was naked and showed multiple cut and stab wounds on different parts of the body (face, neck, chest, abdomen, and extremities). A single-edged kitchen knife was found approximately 20m from the body. Parts of both ears, the fifth toe of the right foot, and the scrotum were cut off. At the autopsy, two of the severed body parts-the toe and the part of the left ear-were found in the stomach. The cause of death was asphyxiation due to blood aspiration resulting from a cut throat injury. A police investigation uncovered a history of substance abuse and two previous suicidal attempts using a knife. Upon complex analysis of all the evidence, the manner of death was ruled a suicide, which was preceded by actions of major self-mutilation and self-cannibalism, both considered rare behavioral patterns.

Our Experience with Cut Throat Injury Cases in a Rural Tertiary Care Centre

ABSTRACT Background: Cut throat injuries are one of the most challenging surgical emergencies encountered by Ear, nose, throat (ENT) surgeons. If not treated in time, they may lead to death. Prevention of mortality depends on immediate resuscitation by securing the airway by tracheostomy or intubation, prompt control of bleeding, and wound closure. Aims and Objectives: Our study was conducted to observe and analyze: 1. The sociodemographic profile of cut throat injury patients admitted in our hospital. 2. The modes of cut throat injury cases admitted in our hospital. 3. Anatomical region and depth of the cut throat injury patients admitted in our hospital. 4. Treatment of cut throat injury patients given at our hospital. Materials and Methods: This is a prospective study of about 25 cases of cut throat injury presented to the emergency department in our tertiary care hospital situated in the rural area of Tamilnadu (India), between June 2021 and September 2022. Cut throat injury patients were managed by multidisciplinary approach headed by the ENT team. Results: In our study, 72% were males and 28% were females. The peak age of incidence is fourth decade (48%). People with lower socioeconomic status were affected more (40%). Eighty percent of the patients had Zone II injuries. Seventy-six percent of cases presented with active bleeding and 60% of cases came with breathing difficulty. The most common cause of cut throat injury had been found to be suicidal (52%). Sixty percent had laryngeal injuries. Seventy-two percent of the cases were managed with tracheostomy. Conclusion: Our study found that the majority of cut throat injury patients were males of age between 30 years to 40 years from poor socioeconomic status. Social involvement and political motivation, poverty reduction, individual awareness, increase in economic growth along with literacy rate will prevent the cut throat injuries. Early and improved proper management will reduce the mortality and morbidity.

THE PATTERN OF CUT THROAT INJURIES, EARLY MANAGEMENT AND OUTCOME-A PROSPECTIVE STUDY IN A TERTIARY CARE HOSPITAL

Objective: To analyze pattern, sex and age ratio, common causes, the most common site and extent of the injury in the patients with cut throat injury at our hospital. To compare the same with previous similar studies conducted at other centers in different parts of the world. Also to note the early management and outcome in our study. Department Setting: of ENT and Head and Neck Surgery, Gauhati Medical college and Hospital, Guwahati, from January 2022 to January 2023. Methods: A total of 60 cases of cut throat injury were included in our study. Proforma was prepared to collect data. Results: 60 cases of cut throat injury patients were included in the study. Out of 60 cases 51 were males and 9 were females. Simple primary wound closure was done in 58 cases and 2 required secondary wound repair. In 20 patients, tracheostomy with primary repair was done. 32 patients needed psychiatric consultation. In our study, Conclusion: majority were males between 20 years to 40 years from lower middle socioeconomic status. Early and improved management will reduce the mortality and morbidity

LARYNGOTRACHEAL TRAUMA MANAGEMENT AND ASSOCIATED MORBIDITY AND MORTALITY: 4-YEAR EXPERIENCE AT A TERTIARY CARE CENTER

Objective: Cut throat injuries pose a great therapeutic challenge due to the multiple vital structures that are vulnerable to injuries in a small, confined unprotected area. In this study, we describe the site and depth of the injury, etiology, management, and prognosis. Methods: This was a retrospective study of 18 laryngotracheal trauma patients treated at the department of ENT in MDM hospital between April 2017 and January 2020. Results: Out of 176 cases of penetrating neck injury, 18 patients presented with a breach in the laryngotracheal framework. Male: female ratio was 17:1. The peak age of incidence is in the 2nd and 4th decade of life. Accidental cut throat injury was the most common mode of injury (83%), followed by homicidal (11%) and then suicidal (5%). Endotracheal intubation (where possible) or emergency tracheostomy was done to secure the airway in all the cases, followed by surgical debridement and laryngeal/hypopharynx repair. Post-operative endoscopy is useful to identify complications. Wound dehiscence was the most common complication. Conclusion: Cut throat injuries are one of the common ENT surgical emergency. Timely intervention is paramount, because it may otherwise cause death of the patient. Securing the airway, control of hemorrhage, and fluid and blood replacement is the mainstay to prevent complications such as shock, sepsis, laryngeal stenosis, or fistula formation.

Accidental Cut Throat Injury by an Unusual Weapon: A Rare Case Report

Accidental Cut Throat Injury by an Unusual Weapon: A Rare Case Report

A clinico epidemiological study of cut throat patients – An observational retrospective study at tertiary care hospital in Jharkhand, India

Background: Cut throat injury is an incised wound in the neck that may be superficial or deep and is usually caused by sharp objects. These wounds may be from homicide, suicide, or accidental. Aims and Objectives: The purpose of this study was to assess cut throat injury in terms of age, sex, site of injury, and triggering factors for suicidal cut throat injury. Materials and Methods: This retrospective study was carried out in the Department of ENT, Rajendra Institute of Medical Sciences. The study included 35 cut throat patients who were admitted and managed in the ENT department. Data were analyzed with detailed history as age, sex, cause, site of injury, sociodemographic pattern, and history of substance abuse, psychiatric problem, and duration of hospital stay. Results: Out of 35 patients, 32 were male and three were female. The majority of the patients 21 (60%) were young adults. Causes of cut throat were suicidal 77.14% followed by homicidal 20%. The majority of patients had Zone II injuries. In general, the patients belonged to the lower middle socioeconomic class. About 77.8% of patients with suicidal cases were found to be addicted to one more substance and 22.2% were having some psychiatric illness. The most common substance abuse was indigenous rice beer Hadia mahua. Conclusion: Young adults of the low socioeconomic class were most vulnerable to cut throat injury with a majority having zone II injury. Suicide was the most common cause with substance abuse proving to be a major provoking factor in addition to unemployment, illiteracy, and poverty.

A Retrospective Study on Patients with ENT Injuries Following Road Traffic Accidents at a Tertiary Care Medical Institution in Sri Lanka

Road traffic accidents (RTAs) and ear, nose, and throat (ENT) injuries are common causative factors of morbidity and mortality among children and adult populations. In developing countries, RTAs are the leading cause of ENT injuries and have a profound impact on the health and well-being of individuals. In Sri Lanka, there is a dearth of published research specifically on ENT injuries due to RTAs. This study was conducted to identify ENT injuries due to RTAs, their prevalence according to age and gender, and the clinical presentation among the patients managed in the National Hospital Kandy (NHK), Sri Lanka. All individuals with ENT injuries following an RTA admitted to the ENT Unit of NHK from January 2016 to March 2019 were included in the study. Patient data were collected from the Bed-Head-Tickets (BHTs) and analyzed. Among the 62 patients studied, 49 were male, while 13 were female. The majority (58%) of patients were among the 21–40- year age group. The nose was observed as the most common localized injury site (58%), followed by the ear (6%), while none had injuries to the throat. Epistaxis was the most commonly observed clinical presentation (69%). The majority of admissions occurred during '18:00-24:00' hours. Nine individuals were under the influence of alcohol. In the future, prospective studies in this area would help further understand ENT injuries due to RTAs.

An atypical suicidal cut throat injury- Mechanism uncovered after injury interpretation

Suicide is an intentional act of injuring oneself, irrespective of the outcome. However, there are other forms of suicidal behaviour existing among the people. The year 2020 is a hard time due to COVID19 pandemic as it had created difficulty to many people especially the lower economic class people to meet their daily livelihood. The result is many poor victims committing suicide. The method used for committing suicide vary from region to region. However, cutting one's own throat to end their life is very rarely performed by the victims of suicide. A careful interpretation of the injury is required by the forensic pathologist to conclude the manner of the death in such deaths. Here we report one such case, and the manner is concluded after studying the injuries tediously in summation with the police investigation.

Effect of budesonide aerosol inhalation on postoperative complications and foreign body sensation in the throat of goiter resection patients

Purpose: To study the effect of budesonide aerosol inhalation on postoperative complications and foreign-body sensation in the throat of patients who underwent goiter resection.Methods: One hundred and twenty patients who underwent goiter resection at The Affiliated Hospital of Putian University (Fujian, China) from January 2019 to January 2020 were included in the study, and then equally and randomly assigned to groups A and B. During the perioperative period, group A patients were given budesonide aerosol inhalation, while group B patients received aerosol inhalation of equivalent volume of normal salineectively. Postoperative complication rate (CR), complication pain scores, scores on mucosal response in the throat, and scores on foreign body sensation in the throat were determined for both groups.Results: Postoperative complications in patients were hoarseness, sore throat and cough. Group A had significantly lower postoperative CR, lower complication pain scores, lower scores on mucosal response in the throat, and lower scores on foreign body sensation in the throat, when compared to group B (p < 0.001).Conclusion: Budesonide aerosol inhalation in patients who underwent goiter resection is effective in relieving throat injury from general anesthesia, minimizing likelihood of postoperative complications, and easing foreign-body sensation in the throat. Thus, this strategy may be suitable for the management of postoperative complications.

Knowledge, Attitudes, and Practices of Self-ear Cleaning in Makkah Region, Cross-sectional Study

Background and aim: Cerumen or ear wax is a normal secretion from sebaceous and ceruminous glands found in the external auditory canal. Wrong self-ear cleaning attempts may lead to cerumen impaction, injuries, and otitis externa. we have concluded this study to assess the local community's knowledge about ear-cleaning, attitudes toward ear care, and self-ear cleaning practices. Methods: Cross-sectional online survey performed in May 2021 among general population to assess knowledge, attitudes, and practices of self-ear cleaning. We included all people aged between 18 to 90 years who live in Makkah region, also we excluded health care workers and who had previous ears, nose, and throat injuries. Results: A total of 544 participants responded to the survey, 351 (64.5%) were males and 193 (35.5%) were females, age between 18 to 55. Forty-four (8.1%) of participants thought that it is harmful to self-clean your ear. In contrast, 274 (50.4%) thought that we do not have to remove the wax from our ears constantly. About 32% of them clean to remove the dirt and 29.30% clean to improve their ear hygiene. Conclusion: Self-ear cleaning is a widespread practice, and most respondents showed a lack of knowledge regarding ear-cleansing mechanisms. In order to rectify the erroneous views, more public health education is needed to dissuade people from practicing self-ear cleaning and teach them about the function of cerumen and problems associated with self-ear cleaning.

Cut Throat Injury: A Tertiary Care Centre Experience

Introduction Cut throat injuries are one of the challenging emergencies encountered in clinical practice. This study evaluates the causes and management of cut throat injuries. Materials and Methods This was a retrospective study of total 100 cases of cut throat injury presented to the department of ENT in a tertiary care hospital in Ahmedabad between June 2017 and June 2019. Majority of patients were managed by suturing. Results In our study 69% were males,31% were females. The peak age of incidence is 4th decade (55%). 70% of them have injury in Zone II. Seventy eight percent of the patients presented with active bleed without major vessel injury. The most common cause of cut throat injury had been found to be accidental (75%), 54% had injury up to muscular layer. Five patients were managed by laryngotracheal stent placement. Conclusion The middle aged males were mostly affected. The majority had zone 2 injury. The most common cause was Accidental (seasonal manja/ kite thread cut). Primary repair is the best way to avoid complications.

Familicide-suicide by cut throat by a safety razor blade along withatypical hesitation wounds

A coupleand their two daughterswere found lying in a pool of blood in the bedroom by the police. A safety razor blade had been recovered at crime scenes. Cut throat injuries were present on all the persons. The husband brought dead to a hospital and later the younger daughter also succumbed to the injuries. Medico legal autopsy and investigation by the police confirmed the caseas familicide-suicide and the perpetrator was the husband.Hewas suspecting infidelity of his wife and was in depression.To the authors’ knowledge both homicide and suicide by cut throat with a safety razor blade has not been described before.Also, in this paper, we are highlighting atypical hesitation cut on the posterior neck of the perpetrator.

An Epidemiological Study of Cut Throat Injury During COVID-19 Pandemic in a Tertiary Care Centre

To find out incidence, prevalence, various modes and pattern of cutthroat injury during COVID-19 pandemic and compare with prior non pandemic period. To find out the various factor influencing the suicidal cutthroat and establish the temporal association of suicidal cutthroat with COVID-19 pandemic. It is a retrospective study of cutthroat patients who were managed in ENT Dept. VIMSAR, Burla, Sambalur, Odisha, India from 1st September 2019 to 31st August 2020. Source of information are casualty, IPD and OT registers and online data. Total cases were divided into group-A (prior to COVID-19 pandemic) and group-B (during COVID-19 pandemic) and analysed. Total 24 cutthroat injury cases were treated over 1 year in department of ENT, VIMSAR, Burla, which was 0.054% of total cases attended at casualty and 2.371% of total IPD patients treated. In GROUP-A, total 10 cases with M:F = 9:1,suicidal 4 cases (40%), homicidal 6 cases (60%), and no accidental cases were recorded. While in GROUP-B, total 14 case with M:F = 14:0, suicidal 9 cases (64.28%), homicidal 3 cases (21.42%) and accidental 2 (14.28%) cases were recorded. In our study majority of cases were male with M:F = 23:1. Common age group belongs to 20–30 years with LSES and farmer by occupation. Zone II injury had incidence of 70.83%. Homicide cases proportionally high during non-COVID period while suicide cases high during COVID-19 pandemic. Association of COVID-19 pandemic with suicidal cut throat injury is seems to be significant. Among predisposing risk factors for suicidal, depression during COVID-19 pandemic had seen in 53.84% of total suicidal cases. Incidence and prevalence of Cut throat injury is comparatively high in western odisha which again increases during months of July and August parallel to COVID-19 pandemic. The common mode of cutthroat injury is homicidal, which suddenly changes to suicidal during COVID-19 pandemic. More vulnerable groups were young unemployed male, farmers and labours. Cutthroat injury cases definitely increases during COVID-19 pandemic with most common mode of injury being suicidal attempt, which may be due to economical and psychological imbalances, due to loss of job and fear and social stigma for COVID-19 diseases.

An Attempted Homicidal Cut Throat Injury: A Case Study

Homicidal cut throat is an injury over the front of neck by sharp instruments with an intent of murder. The neck contains vital structures (nerves, blood vessels, airway and pharyngeal conduit) in a compact fashion that may be difficult to access for physical examination or surgical exploration in a limited time. That is why these cases create panic and pose great challenges in the management. Here is a case of an attempted homicidal cut throat injury that highlights some of the challenges encountered in the management along with discussion on the evolving knowledge of the optimal management practice.

Anti-inflammatory effect of Ganluyin, a Chinese classic prescription, in chronic pharyngitis rat model

BackgroundGanluyin (GLY) is a famous classical prescription with a long history of use as a treatment for inflammatory conditions such as chronic pharyngitis (CP) in many parts of China. However, it has not been developed as a modern pharmaceutic and its anti-inflammatory mechanisms remain unclear. The aim of this study was to assess the anti-inflammatory efficacy of GLY and potential mechanisms in a rat model of CP.MethodsThe chemical profile of GLY was analyzed by HPLC-UV. We used a mouse model of ear edema and a rat model of paw edema. Specifically, xylene was used to induce edema on the surface of one ear in mice, and carrageenan was injected subcutaneously into the right hind paws of rats to induce paw edema. The paw thickness, ear weight, and ear perfusion were measured and recorded. The CP model in rats was induced by irritating the throat with 5% ammonia and was used to evaluate the therapeutic efficacy of GLY. Levels of interleukin-6 (IL-6), interleukin-1β (IL-1β), tumor necrosis factor (TNF-α), and prostaglandin E2 (PGE2) were measured by ELISA in serum, and protein expression of cyclooxygenase-2 (COX-2) and nuclear factor kappa-B p65 (NF-κB p65) in the throat were detected by immunohistochemistry and Western blot to evaluate the anti-inflammatory mechanism of GLY. Hematological assays were also conducted.ResultsThere were four flavonoids identified in GLY: naringin, neohesperidin, baicalin, and wogonoside. The oral administration of GLY showed a significant inhibitory effect on xylene-induced ear swelling and ear blood flow in mice and significantly ameliorated rat right hind paw edema at doses of 6.2 and 12.4 g/kg. Mechanistic studies found that the anti-inflammatory activity of GLY was related to the inhibition of pro-inflammatory cytokines such as IL-1β, IL-6, TNF-α, and PGE2 and that GLY reduced the expression of COX-2 and NF-κB p65 proteins in the throat, attenuated throat injury, and reduced inflammatory exudates. Hematological analysis showed that treatment with GLY prevented increases in white blood cell (WBC), neutrophil (NEUT), lymphocyte (LYMPH) and monocyte (MONO) levels.ConclusionsThese studies indicated that GLY has beneficial anti-inflammatory effects on CP and that it acts through reducing pro-inflammatory factors such as IL-1β, IL-6, TNF-α, and PGE2, as well as decreasing WBC, NEUT, LYMPH and MONO levels and decreasing the expression of COX-2 and NF-κB p65 proteins. These findings may lay the groundwork for further studies of GLY as a suitable candidate for the treatment of inflammatory diseases such as CP.

Psychosocial effect of COVID-19 lockdown suicidal cut throat injury: a case report

<p>The novel coronavirus pandemic of 2020 presents vast challenges to the population particularly to vulnerable ones such as those with addictive disorders amid lockdown with no access to alcohol and difficult to reach overburdened healthcare. We present such a case of a 45 years old alcohol dependent in withdrawal with self-inflicted cut throat injury.</p>

Exceptionally Unusual Case of a Self-Inflicted Suicidal Cut Throat Injury

Here we present a 43-year-old man who was brought with a self-inflicted cut throat injury; 18 hours after the suicidal attempt. On examination a deep 12 cm cut at the level of the hyoid bone exposing the posterior pharyngeal wall was seen. Emergency surgery with primary repair, tracheostomy and feeding gastrostomy was done. Post-operative period was uneventful and patient recovered without any speech or swallowing abnormalities. Through this article we would like to stress that even in cases of frightening ghastly wounds, by maintaining simple surgical principles we can achieve good outcomes. Keywords: Throat; Injuries; Neck; Suicide