pharyngeal trauma
Introduction
Brief introduction to pharyngeal trauma Pharyngeal trauma is caused by foreign body damage, iatrogenic injury, chemical corrosion and burns, which can occur alone, often accompanied by oral or throat esophageal injuries. Trauma in the mouth and oropharynx is caused by the fall of the child's mouth hard body. The stab wounds are mostly in the soft palate, hard palate, posterior pharyngeal wall, pharyngeal wall and cheek, etc., and submucosal congestion, hematoma, and muscular layer may occur. Irregular tears or perforations, such as improper treatment can cause infection in the posterior pharynx or pharyngeal side, and abscesses occur. The wounds in the nasopharynx are mostly due to bullets, shrapnel through the nasal cavity, sinuses, eyelids or neck side. They can also be affected by accidents caused by car accidents, facial injuries and skull base fractures. These injuries are more serious and the amount of bleeding is serious. Large, if you flow into the respiratory tract can cause cough, suffocation, excessive bleeding can cause shock, and some wounded may be accompanied by cerebrospinal fluid rhinorrhea. basic knowledge The proportion of illness: 0.001% Susceptible people: no special people Mode of infection: non-infectious Complications: laryngeal edema, difficulty swallowing
Cause
Pharyngeal traumatic cause
External injury to the mouth, pharynx, foreign body injury (such as fish bones, bone fragments), iatrogenic injury (such as endoscopy, endotracheal intubation, nasal feeding tube, proliferative surgery), chemical corrosion injury, scald, clinically common Children, mouth chopsticks, pencils, toy handles, etc., inadvertently fall and damage the mouth and throat, such damage is more common with simple soft tissue injuries.
Prevention
Pharyngeal wound prevention
Attention should be paid to the use of antibiotics to prevent infection, to prevent scarring stenosis, and to treat complications.
Complication
Pharyngeal trauma complications Complications, laryngeal edema, difficulty swallowing
Contusion or blast injury or accompanied by laryngeal injury can cause edema of the throat, hematoma, laryngeal cartilage fracture and difficulty in breathing, penetrating wound can cause wound drooling and dysphagia, secondary infection of the wound has systemic symptoms such as fever.
Symptom
Pharyngeal trauma symptoms Common symptoms Abscess hyperthermia hypertrophy hypertrophy dysphagia dyspnea suffocation shock cerebrospinal fluid rhinorrhea
The wounds in the nasopharynx are mostly due to bullets, shrapnel through the nasal cavity, sinuses, eyelids or neck side. They can also be affected by accidents caused by car accidents, facial injuries and skull base fractures. These injuries are more serious and the amount of bleeding is serious. Large, if you flow into the respiratory tract can cause cough, suffocation, excessive bleeding can cause shock, and some wounded may be accompanied by cerebrospinal fluid rhinorrhea.
Trauma in the mouth and oropharynx is caused by the fall of the child's mouth hard body. The stab wounds are mostly in the soft palate, hard palate, posterior pharyngeal wall, pharyngeal wall and cheek, etc., and submucosal congestion, hematoma, and muscular layer may occur. Irregular tears or perforations, such as improper treatment can cause infection in the posterior pharynx or pharyngeal side, and abscesses occur.
Trauma caused by esophagoscopy often occurs in the lower edge of the piriform fossa or the pharyngeal muscle. Whether it is a severe abrasion of the mucosa or a perforation of the cervical esophagus may cause upper vertical dislocation or abscess, it is characterized by high fever and sternal rear Pain and radiation to the shoulders on both sides, difficulty breathing and increased intrathoracic pressure, difficulty swallowing and subcutaneous emphysema.
The mucosal reaction of pharyngeal burns, burns or chemical corrosion wounds appeared within 2 hours after injury, reached a peak at 4-6 hours, and began to subside after 12 hours, but it was followed by infection, and the degree of mucosal reaction was divided into 3 degrees:
I degree: diffuse hyperemia and edema of the mucosa automatically disappear within 3 to 5 days.
II degree: significant bleeding and edema of the mucosa, sometimes forming serous blisters, erosion of the mucosal surface and fibrinous pseudomembrane, adjacent lymph nodes, about 7 to 14 days subsided.
III degree: often chemical injury, damage to the submucosal layer and surrounding muscle layer tissue, mucosal ulcer, deep necrosis, sustained inflammation, lasting 3 to 4 weeks, after the dislocation and granulation, scar tissue is formed, causing local stenosis Even blocking, hindering swallowing and breathing.
Examine
Examination of pharyngeal trauma
First of all, pay attention to the general condition of the patient, such as breathing, pulse, blood pressure, etc., internal stab wound, often injured and oropharyngeal wall or soft palate, pharyngeal hemorrhage and hematoma, mucosal rupture, uvula, submucosal blood stasis, It is blue-violet and swollen. The neck is often swollen or has ecchymosis. If there is bleeding and emphysema in the soft tissue of the neck, the neck is thick. If there is a laryngeal contusion, there may be a laryngeal cartilage fracture and dislocation. Although small, but the damage is deep, mostly complicated by subcutaneous emphysema and hemoptysis, cut more common in the neck of the neck, more common in the transverse incision, mostly located in the thyroid tongue periosteum and thyroid cartilage, often due to platysma and neck Longitudinal muscle contraction to expand the wound, severe open throat trauma patients, often through the wound to see the pharyngeal wall and laryngeal tissue, gunshot wounds, wounds and other traumatic range, often accompanied by large blood vessels, cervical vertebrae, Cervical trachea or esophageal trauma, the wound is located in the large vessel part of the neck, the examination should be cautious, prepare good lighting equipment and rescue hemostasis equipment, otherwise you can not rush to take out the clots or foreign bodies in the wound, and should not use probes Wound, so as not to cause bleeding.
Diagnosis
Diagnostic diagnosis of pharyngeal trauma
Diagnosis can be based on medical history and clinical manifestations without identification.
