Humans ; Neck Injuries/surgery* ; Carotid Artery Injuries/surgery* ; Neck ; Bone Screws/adverse effects* ; Carotid Artery, Common/surgery*

Humans ; Neck/surgery* ; Orbit/injuries* ; Thorax ; Wounds, Penetrating

OBJECTIVETo study the outcomes of surgeries for acute central cervical spinal cord injury without cervical spine fracture or dislocation in young and middle-aged patients.

METHODSThe clinical data of 58 young and middle-aged patients with acute central cervical spinal cord injury treated in our hospital between August 2005 and August 2009 were analyzed retrospectively. Of these patients, 33 (24 males and 9 females) received surgical treatment and 25 (17 males and 8 females) had conservative therapy. The ASIA grade and ASIA motor and sensory score were used for evaluation at admission and at 14 days and 1 year after the treatment. The neurological symptoms and treatment outcomes in the two groups were evaluated.

RESULTSThe proportion of patients with ASIA grade D-E and the ASIA motor and sensory scores were all significantly higher in the surgical group than in the non-surgical treatment group (P<0.05).

CONCLUSIONFor young and middle-aged patients with central cervical spinal cord injury, immediate surgery can relieve the pressure on the injured spinal cord and improve the micro-circulation to promote functional recovery of the spinal cord.

Adult ; Cervical Vertebrae ; injuries ; surgery ; Female ; Humans ; Joint Dislocations ; surgery ; Male ; Middle Aged ; Neck Injuries ; surgery ; Retrospective Studies ; Spinal Cord Injuries ; surgery ; Spinal Fractures ; surgery ; Young Adult

OBJECTIVE: To explore the management of the laryngeal injury. METHOD: The forty five patients of laryngeal injury had been rescued. Twenty eight patients were treated with the tracheotomy and twenty four patients of them were treated with the laryngoplasty. RESULT: All the patients were survived. Tracheostomy tube of twenty eight patients was taken away without the cicatricial structure of larynx. CONCLUSION With the reasonable management after the laryngeal injury, the injury could be cured in time without complications.
Adolescent ; Adult ; Aged ; Female ; Humans ; Larynx ; injuries ; Male ; Middle Aged ; Neck Injuries ; surgery ; Young Adult

PURPOSE: There are many infectious and inflammatory causes for elevated core-body temperatures, though they rarely pass 40 ℃ (104 ℉). The term "quad fever" is used for extreme hyperpyrexia in the setting of acute cervical spinal cord injuries (SCIs). The traditional methods of treating hyperpyrexia are often ineffective and reported morbidity and mortality rates approach 100%. This study aims to identify the incidence of elevated temperatures in SCIs at our institution and assess the effectiveness of using a non-invasive dry water temperature management system as a treatment modality with mortality. METHODS: A retrospective analysis of acute SCI patients requiring surgical intensive care unit admission who experienced fevers ≥ 40 ℃ (104 ℉) were compared to patients with maximum temperatures < 40 ℃. Patients ≥18 years old who sustained an acute traumatic SCI were included in this study. Patients who expired in the emergency department; had a SCI without radiologic abnormality; had neuropraxia; were admitted to any location other than the surgical intensive care unit; or had positive blood cultures were excluded. SAS 9.4 was used to conduct statistical analysis. RESULTS: Over the 9-year study period, 35 patients were admitted to the surgical intensive care unit with a verified SCI. Seven patients experienced maximum temperatures of ≥ 40 ℃. Six of those patients were treated with the dry water temperature management system with an overall mortality of 57.1% in this subgroup. The mortality rate for the 28 patients who experienced a maximum temperature of ≤ 40 ℃ was 21.4% (p = 0.16). CONCLUSION The diagnosis of quad fever should be considered in patients with cervical SCI in the presence of hyperthermia. In this study, there was no significant difference in mortality between quad fever patients treated with a dry water temperature management system versus SCI patients without quad fever. The early use of a dry water temperature management system appears to decrease the mortality rate of quad fever.
Humans ; Adolescent ; Hyperthermia ; Retrospective Studies ; Cervical Cord ; Spinal Cord Injuries/surgery* ; Neck Injuries ; Soft Tissue Injuries ; Hyperthermia, Induced

Migration of metallic foreign body into the cerebral circulation is rarely seen. Most of the cases reported were due to gunshot wounds and shotgun wounds to the neck and face. When the foreign body is near the great vessel, it must be removed immediately or will cause complications. This study reported a case of delayed metallic foreign body embolus to the ophthalmic artery resulting from an injury to the right neck, which arose from the presence of metallic emboli to the cerebral circulation.
Adult ; Embolism ; diagnosis ; surgery ; Foreign Bodies ; diagnosis ; surgery ; Humans ; Male ; Neck Injuries ; complications ; surgery ; Ophthalmic Artery ; injuries ; pathology ; surgery ; Wounds, Penetrating ; complications

Although penetrating neck trauma (PNT) is uncommon, it is associated with the significant morbidity and mortality. The management of PNT has changed significantly over the past 50 years. A radiological assessment now is a vital part of the management with a traditional surgical exploration. A 22 years old male was assaulted by a screwdriver and sustained multiple penetrating neck injuries. A contrast CT scan revealed a focal pseudoaneurysm in the left common carotid artery bulb. There was no active bleeding or any other vascular injuries and the patient remained haemodynamically stable. In view of these findings, he was initially managed conservatively without an open surgical exploration. However, the patient was noted to have an acute drop in his hemoglobin count overnight post injury and the catheter directed angiography showed active bleeding from the pseudoaneurysm. Surgical exploration 40 hours following the initial injury revealed a penetrating injury through both arterial walls of the left carotid bulb which was repaired with a great saphenous vein patch. A percutaneous drain was inserted in the carotid triangle and a course of intravenous antibiotics for five days was commenced. The patient recovered well with no complications and remained asymptomatic at five months followup.
Carotid Artery Injuries ; diagnostic imaging ; surgery ; Carotid Artery, Common ; surgery ; Computed Tomography Angiography ; Humans ; Male ; Neck Injuries ; diagnostic imaging ; surgery ; Wounds, Penetrating ; diagnostic imaging ; surgery ; Young Adult

OBJECTIVETo observe the therapeutic effect of supraclavicular island flap in repairing deep burn wound of neck.

METHODSSix patients with deep burn of neck hospitalized from January 2009 to June 2011 were enrolled in the study. Their total burn area ranged from 6% to 22% TBSA, of which full-thickness area ranged from 3% to 22% TBSA. The neck wound ranged from 12 cm x 5 cm to 15 cm x 8 cm in area, and they were all full-thickness in depth. One of the neck wounds was covered with granulation tissue. Patients underwent either debridement and escharectomy or excision of granulation tissue for the neck wound, and they were covered with supraclavicular island flap designed with the size corresponding to that of wound area. Four donor sites were sutured directly. The other two donor sites were covered with free skin graft. Survival of flaps and healing of donor sites were observed. The appearance and function recovery of operative regions were followed up.

RESULTSSupraclavicular island flaps of 6 patients survived as a whole. All the donor sites healed well. Flaps with satisfactory appearance and feeling sensation, accompanied by unlimited extension of neck were observed in the follow-up duration from 6 to 12 months. Scars observed in the flap edge and the donor sites were linear, and they did not affect the overall appearance and function of patients.

CONCLUSIONSSupraclavicular island flap is a good choice for repairing deep burn wound of neck, and it gives a good shape and function recovery of the neck.

Adult ; Burns ; surgery ; Female ; Humans ; Male ; Middle Aged ; Neck Injuries ; surgery ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; methods ; Soft Tissue Injuries ; surgery ; Surgical Flaps

Humans ; Male ; Myocutaneous Flap ; Neck Injuries ; etiology ; surgery ; Pectoralis Muscles ; transplantation ; Radiation Injuries ; surgery ; Reconstructive Surgical Procedures ; methods ; Skin Ulcer ; etiology ; surgery ; Tissue Transplantation ; methods

Aged ; Bone Wires ; adverse effects ; Clavicle ; injuries ; surgery ; Fracture Fixation, Internal ; adverse effects ; Humans ; Male ; Neck