Emergent Reconstruction of Laryngeal Penetrating Neck Injury: A Case Report

Objective: This paper aims to describe an unconventional surgical procedure performed in a case of penetrating neck injury involving the larynx. Methods: Design: Case Report Setting: Tertiary Government Hospital Population:          One Results: A 38-year-old man sustained a hacking l...

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Bibliographic Details
Main Authors: Ruthlyn Pecolera, Rubiliza Onofre-Telan
Format: Article
Language:English
Published: Philippine Society of Otolaryngology-Head and Neck Surgery, Inc. 2019-12-01
Series:Philippine Journal of Otolaryngology Head and Neck Surgery
Subjects:
Online Access:https://pjohns.pso-hns.org/index.php/pjohns/article/view/105
Description
Summary:Objective: This paper aims to describe an unconventional surgical procedure performed in a case of penetrating neck injury involving the larynx. Methods: Design: Case Report Setting: Tertiary Government Hospital Population:          One Results: A 38-year-old man sustained a hacking laceration to the anterior neck that extended into the hypopharyngeal area, transecting the thyroid cartilage. After pre-emptive tracheostomy, the patient was referred to otorhinolaryngology – head and neck surgery due to the extensive hypopharyngeal injury. Neck exploration performed to control bleeders confirmed a Schaefer-Fuhrman Classification Group 3 penetrating neck injury. Anastomotic reconstruction of the hypopharynx, transected thyroid cartilage and strap muscles was attempted using absorbable sutures with post-operative re-establishment of structural continuity and documentation of full bilateral vocal fold mobility. The patient was about to be discharged home with a tracheotomy and nasogastric tube when he suddenly deteriorated and expired on the eighth post-operative day. Conclusion:  Our technique might be utilized in cases where urgent reconstruction of laryngeal structures is considered despite serious damage to the laryngeal skeleton, and may provide a temporary surgical option for similar cases in an emergent setting. However, we cannot recommend it as a routine standard on the basis of one case. Keywords:  larynx; penetrating neck injury; vocal cord; reconstruction, neck exploration
ISSN:1908-4889
2094-1501