Epidemiology, Mode of Injury, and Treatment Outcomes in Neck Trauma: A Retrospective Study

This study aimed to evaluate the epidemiological profile, injury patterns, anatomical involvement, management strategies, and clinical outcomes of patients presenting with neck trauma at a tertiary-care center. In addition, the study sought to identify demographic and clinical predictors of emergency airway intervention (tracheostomy) and psychiatric morbidity and to analyze their association with key clinical outcomes using appropriate statistical methods, including multivariate analysis.

This retrospective observational study was conducted in the Department of Otorhinolaryngology and Head and Neck Surgery at a tertiary-care teaching hospital from January 2013 to March 2025. Patients of all ages presenting with blunt or penetrating neck trauma who underwent surgical exploration were included through consecutive sampling. Data regarding demographics, mechanism of injury, anatomical zone (Roon and Christensen classification), structural involvement, surgical procedures, and outcomes were retrieved from medical records. All patients were managed according to Advanced Trauma Life Support (ATLS) principles, with priority given to airway stabilization followed by appropriate surgical intervention.

A total of 51 patients were included. Most were male (47, 92.2%), and 28 (54.9%) were older than 30 years. Suicidal injury was the most common mechanism (27, 52.9%), with sharp trauma reported in 39 (76.4%) cases. Zone II was the most frequently involved anatomical region (33, 64.7%). A tracheal breach was observed in 30 (58.8%) patients, a cricothyroid tear in 16 (31.3%), and a major vascular injury in 11 (21.5%). Emergency tracheostomy was required in 24 (47.1%) patients, whereas 16 (31.4%) underwent primary repair without tracheostomy. Successful decannulation was achieved in 23 (45.1%) patients, and only one (2%) patient required permanent tracheostomy. Psychiatric morbidity was identified in 23 (45.1%) patients. Most patients (37, 72.5%) had a hospital stay of 5-10 days.

Neck trauma predominantly affected young adult males and was most commonly caused by suicidal sharp injuries involving Zone II. Laryngotracheal injuries were frequent and often necessitated emergency tracheostomy; however, overall airway outcomes were favorable, with most patients successfully decannulated. Major vascular injuries occurred in a notable proportion of cases, requiring prompt surgical management. The high rate of postoperative psychiatric morbidity underscores the importance of integrating mental health support into trauma care to optimize overall outcomes.