Neck Trauma, Penetrating, Anterior



  • 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


  • Gunshot wounds
  • Stab wounds
  • Miscellaneous (e.g., glass shards, metal fragments, animal bites)

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