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War injuries to the head and neck

D Danić1, D Prgomet, D Milicić

  • 1Department of Otorhinolaryngology and Cervicofacial Surgery, Dr Josip Bencević General Hospital, Slavonski Brod, Croatia.

Military Medicine
|March 21, 1998
PubMed
Summary

This study analyzed 728 head and neck war injuries during the 1991-1992 Croatian War, primarily from shell fragments. Novel surgical techniques for head and neck trauma were introduced.

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Area of Science:

  • Otorhinolaryngology
  • Cervicofacial Surgery
  • War Surgery

Background:

  • The 1991-1992 war in Croatia resulted in numerous casualties requiring specialized medical treatment.
  • Dr Josip Bencević General Hospital treated 7,043 wounded individuals, with a significant subset presenting head and neck injuries.

Purpose of the Study:

  • To analyze the characteristics and treatment outcomes of war-related head and neck injuries.
  • To document the initial application of specific surgical procedures in a wartime setting.

Main Methods:

  • Retrospective analysis of 728 patients with head and neck war injuries admitted to the Department of Otorhinolaryngology and Cervicofacial Surgery.
  • Classification of injuries (head, neck, combined) and wound etiologies (shell/bomb fragments).
  • Description of preliminary and definitive treatment strategies, including immediate neck exploration and novel reconstruction techniques.

Main Results:

  • Head injuries were most common (74.3%), followed by neck injuries (16.0%) and combined injuries (9.6%).
  • Shell and bomb fragments accounted for 74.5% of the injuries.
  • Exploration of penetrating neck wounds was positive in 49 of 84 patients. Long-term complications included cranial plexus paralysis and neurological deficits.

Conclusions:

  • War injuries to the head and neck present a significant challenge, often caused by explosive fragments.
  • Primary wound closure with antibiotics and reconstruction of laryngotracheal injuries using cervical deep fascia represent innovative war surgery procedures.
  • These novel techniques, applied during the conflict, may offer improved outcomes for severe head and neck trauma in wartime.

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