Neck Trauma, Penetrating, Anterior

Basics

Wound severity gauged by violation of platysma muscle
Neck is divided into 3 zones:
- Zone I: Between clavicles and cricoid cartilage:
  - Involves vessels, lungs, trachea, esophagus, thyroid
  - Penetrating trauma in this zone carries highest mortality owing to injury to thoracic structures
- Zone II: Between cricoid cartilage and angle of mandible:
  - Involves vessels, trachea, esophagus, C-spine, and spinal cord
  - Injuries are most common in this zone due to it being most exposed region
- Zone III: Above angle of mandible to base of skull:
  - Injuries are difficult to access surgically
Newer literature supports an alternate “no-zone” approach:
- External wound often does NOT correspond to the internal injury

Pediatric Considerations
Larynx is located higher in neck and receives better protection from mandible and hyoid bone

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