Emergent Reconstruction of Laryngeal Penetrating Neck Injury: A Case Report

Abstract

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

Keywords

• larynx
• penetrating neck injury
• vocal cord
• reconstruction
• neck exploration