throat cut
Introduction
Introduction to laryngeal injury Laryngeal injury is an open throat injury. Trauma can involve laryngeal cartilage, fascia of the larynx, etc. Such as through the throat, it is called penetrating laryngeal trauma. Most of the laryngeal injuries are self. Usually, those who are clinically seen are mostly those who have suicide attempts and half of them are stab wounds. The cut with the sharp neck is mostly rampant. According to the comprehensive statistics of various reports at home and abroad, the thyroid cartilage accounted for the first place (33.0%), followed by thyroid periosteum (31.1%), ring membrane (12.1%), and ring cartilage (9.8%). Trachea (8.0%), above the hyoid bone (5.7%). Symptoms are nothing more than hoarseness, aphasia, difficulty breathing, coughing, hemoptysis, etc. Mainly to stop bleeding, anti-shock and relieve breathing difficulties. Check the wound, look for bleeding points, and properly ligature the bleeding blood vessels. If the location of the bleeding is deep, it is not easy to ligature and stop bleeding. The gauze can be used to stop bleeding on both sides of the throat and trachea. Use the aspirator to remove the blood in the larynx and trachea, and insert the tracheal cannula from the incision to ensure the airway is unobstructed. basic knowledge The proportion of sickness: 0.2% Susceptible people: no specific population Mode of infection: non-infectious Complications: mediastinal emphysema, tracheoesophageal fistula, pneumonia
Cause
Cause of laryngeal injury
1. Firearm injuries include guns, guns, shrapnel and bayonets. Bullets are generally penetrating wounds and the range is limited. The shrapnel can break the entire throat and have a wide range of damage.
2. Inadvertently hit the debris during the blasting of the industrial and mining, or the explosives in the workshop.
3. In a traffic accident, the throat is injured by glass or iron.
4, sharp injuries in the bucket, or intentionally committed suicide with a knife.
Prevention
Laryngeal injury prevention
Take care to protect yourself from trauma. Control the infection; if necessary, place the drainage; the narrow injury should be cut open to facilitate drainage; if the wound has signs of infection or suppuration, the suture should be removed in time, open, wet drainage, to prevent infection from spreading to the deep, And watch closely.
Complication
Laryngeal complications Complications, mediastinal emphysema, tracheoesophageal fistula, pneumonia
Complications may include wound infection, perichondritis, difficulty in extubation, secondary bleeding, subcutaneous emphysema in the neck, mediastinal emphysema, vocal cord paralysis, tracheoesophageal fistula, pneumonia and mediastinal inflammation.
Symptom
Symptoms of laryngeal injury Common symptoms Arterial bleeding, dyspnea, difficulty swallowing, venous bleeding, subcutaneous emphysema, hoarseness
1, bleeding
Most of the bleeding comes from the laryngeal artery, the sublingual branch of the facial artery, the thyroid artery or the thyroid tissue. Because of the abundant blood vessels, the bleeding is often serious and prone to shock. If the carotid artery and jugular vein are severed and ruptured, they will die as soon as they seek medical treatment.
2, subcutaneous emphysema
Because of coughing, the intrathoracic pressure increases, the air enters the soft tissue of the neck from the rupture of the laryngeal mucosa and the subcutaneous emphysema occurs, or the air penetrates from the neck and the throat through the wound into the subcutaneous tissue space, which can be extended to the face, chest and abdomen. .
3, difficulty breathing
Due to cartilage fracture, mucosal bleeding, swelling caused. It may also cause blood retention due to blood flowing into the lower respiratory tract, trachea, and bronchus, or emphysema and pneumothorax may cause difficulty in breathing. The above three symptoms are critical.
4, sonar
Trauma in the glottic area and subglottic area, due to damage to the vocal cords or recurrent laryngeal nerves, often have hoarseness and even loss of sound.
5, difficulty swallowing
Often because of sore throat, the swallowing action is hindered. If the pharynx, piriform fossa or upper esophagus is worn through, and saliva leaks out, swallowing is more difficult. Because the throat wound communicates with the outside of the neck, saliva and food can flow out of the wound.
6, the wound situation
The shape of the wound is related to the injury device. When the knife is cut, the skin has a large wound and the edges are neat, often a single incision. Scissors, daggers and other sharp sharps of the stab wound, skin wounds are small, multiple, often accompanied by severe emphysema. Cannonball wounds, mostly untidy wounds, often left behind in soft tissue.
Examine
Laryngeal injury examination
Laryngoscopy, direct observation.
1. Submucosal hematoma, hemorrhage, and even muscle necrosis appearing away from the injured. The range of bleeding along the direction of the muscle fibers can be very large. If the fascia that envelops the muscles is not fully cut, the chance of developing fascial syndrome will increase.
2. Although the projectile does not touch the bone, an indirect fracture may occur, which is characterized by a transverse or small bevel fracture.
3. Damage to tissues and organs outside the wound.
Diagnosis
Diagnosis and differentiation of laryngeal incision
diagnosis
Direct visual observation is visible. It can be diagnosed based on clinical symptoms and laboratory data.
