Cases reported "Neck Injuries"

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1/288. Treatment of a neck burn contracture with a super-thin occipito-cervico-dorsal flap: a case report.

    Postburn neck contractures still represent a surgical challenge due to their exposed location; and early operative treatment is necessary for both functional as well as aesthetic reasons. An excellent functional result was obtained by using a supercharged super-thin occipito-cervico-dorsal flap described by Hyakusoku to repair a large defect of the anterior neck following a very wide neck burn contracture release. In this case report, the technique and its advantages among the other reconstructive modalities are discussed briefly.
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2/288. head and neck reconstruction using lateral thigh free flap: flap design.

    Eleven lateral thigh free flaps were used in head and neck reconstruction, transferred on the basis of the second perforator as well as the third perforator of the profunda femoris artery. The lateral thigh free flap was useful and reliable in head and neck reconstruction and was versatile in flap design. Due to the wide cutaneous territory of the lateral thigh flap, the skin island could be designed freely in the lateral thigh region. Careful patient selection is mandatory for good results. The pinch test and an understanding of the variety of subcutaneous thicknesses in the lateral thigh region are helpful in designing a skin island of adequate thickness. Other considerations in flap design are discussed.
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3/288. Traumatic dissection of the common carotid artery after blunt injury to the neck.

    BACKGROUND: Occlusive lesions of the common carotid artery (CCA) resulting from blunt injury are extremely rare, and their clinicopathologic and therapeutic features have not yet been clarified. OBJECTIVES AND RESULTS: Five patients with occlusive lesions of the CCA developed neurologic deficits at 1.5 hours to 10 years after blunt neck injury. Lesions included two complete occlusions, one severe stenosis, and two segmental intimal dissections of the CCA. In the two patients with CCA occlusion, bypass surgery was performed using a Dacron graft between the ipsilateral subclavian artery and the carotid bifurcation. In the remaining three patients, the involved segments were replaced with a Dacron graft. Surgical specimens from the early posttraumatic period revealed intimal tears with mural thrombosis and/or subintimal hematomas and those from the later period showed myointimal hyperplasia or fibrotic organization. CONCLUSION: Traumatic occlusive lesions of the CCA tend to evolve from intimal dissections to severe stenoses or occlusion, compromising cerebral circulation. The involved CCA can be diagnosed early by B-mode Doppler sonography and successfully reconstructed using a Dacron graft.
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keywords = neck
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4/288. Reconstruction of the neck with two rotation-advancement platysma myocutaneous flaps.

    A reconstruction of a neck with a defect caused by radionecrosis sequelae using two rotation-advancement platysma myocutaneous flaps is presented. The thinness of the flaps, their accessibility, the lack of bulk, and the primary closure of the donor site, without functional or aesthetic problems, all render this technique an attractive option for replacing anterior neck skin.
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5/288. Isolated longitudinal rupture of the posterior tracheal wall following blunt neck trauma.

    The authors report 3 female children (4, 5 and 12 years old) who suffered an isolated rupture of the posterior tracheal wall (membranous part) following a minimal blunt trauma of the neck. Such tracheal ruptures often cause a mediastinal and a cutaneous thoraco-cervical emphysema, and can also be combined with a pneumothorax. The following diagnostic steps are necessary: X-ray and CT of the chest, tracheo-bronchoscopy and esophagoscopy. The most important examination is the tracheo-bronchoscopy to visualize especially the posterior wall of the trachea. Proper treatment of an isolated rupture of the posterior tracheal wall requires knowledge about the injury mechanisms. The decision concerning conservative treatment or a surgical intervention is discussed. In our 3 patients we chose the conservative approach for the following reasons: 1) The lesions of the posterior tracheal wall were relatively small (1 cm, 1.5 cm, 3 cm) and showed a good adaptation of the wound margins. 2) No cases showed an associated injury of the esophageal wall. All of our patients had an uneventful recovery, the lesion healed within 10 to 14 days, and follow-up showed no late complications.
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6/288. Fatal neck injuries caused by blank cartridges.

    We report three cases where fatal neck injuries were caused by blanks from starting pistols. The weapons were loaded with blank cartridges or tear gas cartridges. Neither live ammunition nor any form of projectile was used. All three cases involved a contact discharge. The gas pressure caused by firing the weapons created extensive wound cavities in all three cases. Each victim died from blood loss as a result of ruptured cervical vessels; there were no air embolisms. In one case, a man shot himself eight times with two different starting pistols, and the wounds could be matched to each gun by the muzzle imprint marks on the neck.
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keywords = neck
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7/288. Multivascular trauma on an adolescent. Perioperative management.

    Penetrating vascular injury, in particular at the neck, is a life-threatening trauma not only of the nature and the anatomic proximity of cardiovascular, aerodigestive, glandular and neurologic system but also of the development of early and late complications. The following case report describes our experience with a penetrating wound patient, who was admitted to our emergencies twelve hours after the accident. The only demonstrable objective signs included a large hematoma at the right-side of the neck and distended mediastinum on the chest X-ray. As the patient was cardiovascularly unstable he was immediately transported to the theater without any angiography. The mandatory operative exploration was initially unsuccessful and a median sternotomy with a standard cardiopulmonary bypass and deep hypothermia circulatory arrest was established to restore all the vascular lesions. Actually, the patient was in critical condition with a rupture of the right internal jugular vein, a large pseudoaneurysm of the innominate artery and an avulsion of the ascending aorta with the suspicion of a cardiac tamponade. The postoperative period lasted two full months, while complications appeared. The substantial message from this multivascular trauma is the early diagnosis of the life-threatening complications as exsanguinations, ventricular fibrillation and the ability to minimize postoperative complications, which will impair the normal functional life of the patient.
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ranking = 0.28571428571429
keywords = neck
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8/288. Fatal laryngeal injury in an achondroplastic dwarf secondary to airbag deployment.

    We report the case of an unrestrained driver with achondroplastic dwarfism who suffered a fatal anterior neck injury when her airbag deployed as she rear-ended another vehicle at 30-40 mph. Her short stature and short limbs required her to sit within a handbreadth of the steering wheel, which probably allowed the airbag or airbag cover to strike her neck as it opened. This is the first reported case of fatal injury to a driver with achondroplastic dwarfism.
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keywords = neck
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9/288. Surgical management of acquired laryngopharyngeal fistulae.

    Pathological communication between the food and air passages in the neck region due to malignant disease is known. However, such a pathology arising as a result of a non malignant process is relatively uncommon, and only a handful of reports exists in the literature. The authors describe and discuss the management of two patients with laryngopharyngeal fistula of nonmalignant etiology.
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keywords = neck
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10/288. life-threatening nail gun injuries.

    The use of pneumatic and explosive cartridge-activated nail guns is common in the construction industry. The ease and speed of nailing these tools afford enhance productivity at the cost of increased potential for traumatic injury. Although extremity injuries are most common, life-threatening injuries to the head, neck, chest, or abdomen and pelvis may occur. During a 20-month period, eight potentially life-threatening nail gun injuries were admitted to a Level I trauma center, including injuries to the brain, eye, neck, heart, lung, and femoral artery. Mechanism of injury included nail ricochet, nail gun misuse due to inadequate training, and successful suicide. Nail guns have significant potential for causing severe debilitating injury and death. These findings indicate a need for improved safety features and user education. The various types of nail guns, their ballistic potential, and techniques for operative management are discussed.
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