Airway Issues in Management of Severe Cut-Throat Injuries

Author:

Caleb Manya1ORCID,Hassan Solomon2ORCID,Ibrahim Jibrila3ORCID,Ime Inoh4ORCID,Maisallah Jafar1ORCID,Stephen Yikawe5ORCID

Affiliation:

1. Department of Ear, Nose and Throat Surgery, Federal Medical Centre, Gusau, Nigeria

2. Department of Ear, Nose and Throat Surgery, 063 Nigerian Air Force Hospital, Abuja, Nigeria

3. Department of Anaesthesia, Federal Medical Centre, Gusau, Nigeria

4. Department of Ear, Nose and Throat Surgery, University of Uyo Teaching Hospital, Akwa Ibom, Nigeria

5. Department of Ear, Nose and Throat Surgery, Air Force Hospital, Ikeja, Lagos, Nigeria

Abstract

<i>Introduction:</i> Open or incised anterior neck injuries inflicted by sharp implements may be described as Cut-throat injuries (CTIs). The managing team is immediately confronted with airway management options, therefore, a close collaboration between the surgeon and the anesthetist is required to adopt a strategy that will guarantee a safe airway and ensure a successful outcome. In this article, we discuss the factors that led us to perform tracheostomy before repair while avoiding a rule of tracheostomy for all. <i>Method:</i> A prospective study was conducted at Federal Medical Centre, Gusau, between January 2019 -August 2023. Nine (9) patients presented with zone II cut-throat injuries and the choice of airway management was discussed between the surgeon and the anesthetist focused on symptoms of air obstruction and findings within the larynx that could lead to airway obstruction once repair was done. <i>Result:</i> There were nine patients (9) with the age range of 18-60 years. Tracheostomy rate was 55.6% (n=5). There is a positive correlation (+1) between tracheostomy and laryngeal edema. A subset of patients, 22.2% (n=2) was selected for repair without a tracheostomy. <i>Conclusion:</i> The choice of perfect airway management should result from constructive collaboration between the surgeon and the anesthetist. Tracheostomy should be considered in patients with asymptomatic laryngeal edema.

Publisher

Science Publishing Group

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