Traumatic Neck Injuries

The neck contains critical aerodigestive and neurovascular structures, and damage from penetrating or blunt trauma causes high morbidity and mortality. Understanding the anatomic relationship of the structures within the neck aides in determining what injuries might be present as well as the possible surgical approach. The anatomy of the neck can be divided into anterior and posterior triangles as well as Zones 1 through 3. The zones of the neck are extremely helpful in determining management and treatment decisions. Laryngotracheal, esophageal, vascular, and cervical spine injuries are possible from both penetrating and blunt trauma. A stable patient with neck trauma should undergo a full physical exam as well as computed tomography imaging to determine if surgical intervention is necessary. Endoscopic procedures can aid in diagnosis. An unstable patient with neck trauma, after the initial trauma evaluation, should be further explored in the operating room. While neck trauma is uncommon, it carries one of the highest mortalities. Patients can also develop long-term complications and regular follow-up with someone aware of their injury history is important.