Penetrating injury to the neck has inspired considerable controversy with regard to its management, owing to the large number of important, susceptible structures contained in this area. Mandatory exploration of all wounds has generally given way to selective operative management. Clinical assessment has, once again, become the prime diagnostic tool. This review describes the evolution of management and the value of various diagnostic modalities. It concludes with a summary of appropriate operative techniques.
Apffelstaedt JP, Muller R.1994. Results of mandatory exploration for penetrating neck trauma. World J Surg18: 917-919.
2.
Armstrong WB, Detar TR, Stanley RB.1994. Diagnosis and management of external penetrating cervical esophageal injuries. Ann Otol Rhinol Laryngol103: 863-871.
3.
Asensio J, Belzberg H, Velmahos G, Weaver F, Demetriades D, Theodorou D, Cornwell E, Berne TV, Yellin A.1997a. Evaluation of penetrating injuries of the neck: prospective study of 223 patients. World J Surg21: 41-47.
4.
Asensio JA, Berne J, Demetriades D, Murray J, Gomez H, Falabella A, Fox A, Velmahos G, Shoemaker W, Berne TV.1997b. Penetrating esophageal injuries: time interval of safety for preoperative evaluation-how long is safe? J Trauma43: 319-324.
5.
Asensio JA, Chahwan S, Forno W, MacKersie R, Wall M, Lake J, Minard G, Kirton O, Nagy K, Karmy-Jones R, Brundage S, Hoyt D, Winchell R, Kralovich K, Shapiro M, Falcone R, McGuire E, Ivatury R, Stoner M, Yelon J, Ledgerwood A, Luchette F, Schwab CW, Frankel H, Chang B, Coscia R, Maull K, Wang D, Hirsch E, Cue J, Schmacht D, Dunn F, Miller F, PowellM, Sherck J, EndersonB, Rue L 3rd, Warren R, Rodriguez J, West M, Weircter I, Britt LD, Dries D, Dunham CM, Malangoni M, Fallon W, Simon R, Bell R, Hanpeter D, Garnbaro F, Ceballos J, Torcal J, Alo K, Rarnicone E, Chan L.2001. Penetrating esophageal injuries: multicenter study of the American Association for the Surgery of Trauma. J Trauma50: 289-296.
6.
Atteberry LR, Dennis JW, Menawat SS, Frykberg ER.1994. Physical examination alone is safe and accurate for evaluation of vascular injuries in penetrating zone II neck trauma. J Am Coll Surg179: 657-662.
7.
Beitsch P, Weigelt JA, Flynn E, Easley S.1994. Physical examination andarteriographyin patientswith penetratingzone II neck wounds. Arch Surg129: 577-581.
8.
Biffl WL, Moore EE, Rehse DH, Offner PJ, Francoise RJ, Burch JM.1997. Selective management of penetrating neck trauma based on cervical level of injury. Am J Surg174: 678-682.
9.
Bynoe RP, Miles WS, Bell RM, Greenwold DR, Sessions G, Haynes JL, Rush DS.1991. Noninvasive diagnosis of vascular trauma by duplex ultrasonography. J Vasc Surg14: 346-352.
10.
Corr P, Abdool Carrim AT, Robbs J.1999. Colour-flow ultra-sound in the detection of penetrating vascular injuries of the neck. S Afr Med J89: 644-646.
11.
Demetriades D, Charalambides D, Lakhoo M.1993. Physical examination and selective conservative management in patients with penetrating injuries of the neck. Br J Surg80: 1534-1536.
12.
Demetriades D, Rabinowitz B, Pezikis A, Franklin J, Palexas G.1987. Subclavian vascular injuries. Br J Surg74: 1001-1003.
13.
Demetriades D, Skalkides J, Sofianos C, Melissas J, Franklin J.1989. Carotid artery injuries: experience with 124 cases. J. Trauma29: 91-94.
Demetriades D, Theodorou D, Cornwell E 3rd, Weaver F, Yellin A, Velmahos G, Berne TV.1995. Penetrating injuries of the neck in patients in stable condition. Physical examination, angiography, or color flow Doppler imaging. Arch Surg130: 971-975.
16.
Demetriades D, Theodorou D, Cornwell E, Asensio J, Belzberg H, Velmahos G, Murray J, Berne TV.1996b. Transcervical gunshot injuries: mandatory operation is not necessary. J Trauma40: 758-760.
17.
Demetriades D, Theodorou D, Cornwell E, Berne TV, Asensio J, Belzberg H, Velmahos G, Weaver F, Yellin A.1997. Evaluation of penetratinginjuriesof the neck:a prospectivestudy of 223 patients. World J Surg21: 41-47.
18.
Demetriades D, VandenbosscheP, Ritz M, GoodmannD, Kowalski KJ. 1993. Non-therapeutic operations for penetrating trauma: early morbidity and mortality. Br J Surg80: 860-861.
19.
Eddy VA.2000. Is routine arteriography mandatory for penetrating injury to zone I of the neck? Zone I penetrating neck injury study group. J. Trauma48: 208-213.
Fabian TC, George SM Jr, Croce MA, Mangiante EC, Voeller GR, Kudsk KA.1990. Carotid artery trauma: management based on mechanism of injury. J. Trauma30: 953-961.
22.
Flowers JL, Graham SM, Ugarte MA, Sartor WM, Rodriquez A, Gens DR, Imbembo AL, Gann DS.1996. Flexible endoscopy for the diagnosis of esophagealtrauma. J Trauma40: 261-265.
23.
Gilroy D, Lakhoo M, Charalambides D, Demetriades D.1992. Control of life-threatening haemorrhage from the neck: a new indication for balloon tamponade. Injury23: 557-559.
24.
Ginzburg E, Montalvo B, Le Blang S, Nunez D, Martin L.1996. The use of duplex ultrasonography in penetrating neck trauma. Arch Surg131: 691-693.
25.
Goldberg PA, Knottenbelt JD, van der Spuy JW.1991. Penetrating neck wounds: is evidenceof chest injury an indication for exploration? Injury22: 7-8.
26.
Gonzalez RP, Falimirski ME.1999. The role of angiography in periclavicular penetrating trauma. Am Surg65: 711-713.
Hasaniya N, Demetriades D, StephensA, Dubrowskiz R, Berne T.1994. Early morbidity and mortality of non-therapeutic operations for penetrating trauma. Am Surg60: 744-747.
29.
Hatzitheofilou C, Demetriades D, Melissas J, Stewart M, Franklin J.1998. Surgical approaches to vertebral artery injuries. Br. J. Surg75: 234-237.
30.
Hatzitheofilou C, Strahlendorf C, Kakoyiannis S, Charalambides D, Demetriades D.1993. Penetrating external injuries of the oesophagus and pharynx. Br J Surg80: 1147-1149.
31.
Heary RF, Vaccaro AR, Mesa JJ, Northrup BE, Albert TJ, Balderston RA, Cotler JM.1997. Steroids and gunshot wounds to the spine. Neurosurgery41: 576-583.
32.
Hirshberg A, Wall MJ, Johnston RH Jr, Burch JM, Mattox KL.1994.Transcervicalgunshot injuries. Am J Surg167: 309-312.
33.
Horwitz B, Krevsky B, Buckman RF Jr, Fisher RS, DabeziesMA.1993. Endoscopic evaluation of penetrating esophageal injuries. Am J Gastroenterol88: 1249-1253.
34.
Hyre CE, Cikrit DF, Lalka SG, SawchuckAP, Dalsing MC.1998. Aggressive management of vascular injuries of the thoracic outlet. J Vasc Surg27: 880-884.
35.
Isiklar ZU, Lindsey RW.1998. Gunshot wounds to the spine. Injury29: 7-12.
36.
Jarvik JG, Philips GR 3rd, Schwab CW, Schwartz JS, Grossman RI.1995. Penetrating neck trauma: sensitivity of clinical examination and cost-effectiveness of angiography. Am J Neuroradiol16: 647-654.
37.
Kalakuntla V, Patel V, Tagoe A, Weaver W.2000. Six-year experience with management of subclavian injuries. Am Surg66: 927-930.
38.
Khoury G, Hajj H, Khoury SJ, Basil A, Speir R.1990.Penetrating trauma to the carotid vessels. Eur J Vasc Surg4: 607-610.
39.
Klyachkin ML, Rohmiller M, Charash WE, Sloan DA, Kearney PA.1997.Penetrating injuries of the neck: Selectivemanagement evolving. Am Surg63: 189-194.
40.
Kupcha PC, An HS, Cotler JM.1990. Gunshot wounds to the cervical spine. Spine15: 1058-1063.
41.
Lebos MR, Saadia R.1994. The overlooked blunt component in penetrating neck injuries: three case reports. J Trauma36: 410-411.
42.
Levy ML, Gans W, Wijesinghe HS, SooHoo WE, Adkins RH, StillermanCB.1996.Useofmethylprednisoloneasanadjunct in the management of patients with penetrating spinal cord injury: outcome analysis. Neurosurgery39: 1141-1148.
43.
Luntz M, Nusem S, Kronenberg J.1993. Management of penetrating wounds of the neck. Eur Arch Oto-rhinolaryngol250: 369-374.
44.
Mansour MA, Moore EE, Moore FA, Whitehill TA.1991. Validating the selective management of penetrating neck wounds. Am J Surg162: 517-520.
45.
McKinley AG, Carrim AT, Robbs JV.2000. Management of proximal axillary and subclavian injuries. Br J Surg87: 79-85.
46.
Miller RH, DuplechainJK.1991.Penetratingwounds of the neck. Otolaryngol Clin North Am24: 15-29.
47.
Mittal VK, Paulson TJ, Colaiuta E, Habib FA, Penney DG, Daly B, Young SC.2000. Carotid artery injuries and their management. J Cardiovasc Surg41: 423-431.
48.
Munera F, Soto JA, Palacio D, Velez SM, Medina E.2000. Diagnosis of arterial injuries caused by penetrating trauma to the neck: comparison of helical CT angiography and conventional angiography. Radiology216: 356-362.
Nason RW, Assuras GN, Gray PR, Lipschitz J, Burns CM.2001. Penetrating neck injuries: analysis of experience from a Canadian trauma centre. Can J Surg44: 122-126.
51.
Naude GP, Bongard FS.1998. Base of skull internal carotid and internal jugular gunshot wounds treated conservatively: inadequate treatment, or was well enough left alone? JR Coll Surg Edinb43: 122-124.
52.
Nemzek WR, Hecht ST, Donald PJ, McFall RA, Poirier VC.1996. Prediction of major vascular injury in patients with gunshot wounds to the neck. Am J Neuroradiol17: 161-167.
53.
Ngakane H, Muckart DJ, Luvuno FM.1990. Penetrating visceral injuries of the neck: results of a conservative management policy. Br J. Surg77: 908-910.
Pollack CV Jr, Kolb JC, Griswold JA.1990. Chylous drainage from a stab wound to the neck. Ann Emerg Med19: 1450-1453.
56.
Pringle MB, Charig MJ.1994. The use of digital subtraction angiography in penetrating neck injury-a very instructive case. J Laryngol Otol108: 522-524.
Shearer VE, Giesecke AH.1993. Airway management for patients with penetrating neck trauma: a retrospective study. Anesth Analg77: 1135-1138.
62.
Sofianos C, Degiannis E, Van den Aardweg MS, Levy RD, Naidu M, Saadia R.1996. Selective surgical management of zone II gunshot injuries of the neck: a prospective study. Surgery120: 785-788.
63.
Vassiliu P, Baker J, Henderson S, Alo K, Velmahos G, Demetriades D.2001. Aerodigestive injuries of the neck. Am Surg67: 75-79.
64.
Velmahos G, DemetriadesD.1994.Gunshot wounds of the spine: should retained bullets be removed to prevent infection? Ann R Coll Surg Engl76: 85-87.
65.
Velmahos GC, Souter I, Degiannis E, Mokoena T, Saadia R.1994. Selective surgical management in penetrating neck injuries. Can J Surg37: 487-491.
66.
Walsh MS.1994. The management of penetrating injuries of the anterior triangle of the neck. Injury25: 427-428.
67.
Yee LF, Olcott EW, Knudson MM, Lim RC Jr.1995. Extraluminal, transluminal, and observationaltreatment for vertebral artery injuries. J Trauma39: 480-484.
68.
Yoshida GM, Garland D, Waters RL.1995. Gunshot wounds to the spine. Orthop Clin North Am26: 109-116.
