EXPERIENCE WITH MANAGING PENETRATING ANTERIOR NECK INJURIES IN LAGOS, NIGERIA.

Background: Penetrating anterior neck injuries are potentially life threatening and the causes vary across countries of the world. Studies in Nigeria have been mainly isolated case reports and few retrospective studies.

Aim: The aim of this study was to assess the causes, severity and management outcome of patients treated in our centre.

Methodology: This is a retrospective study of penetrating anterior neck injuries treated at the Lagos University Teaching Hospital over a 25-year period. The case records were retrieved and demographic data as well as the causes, site, extent of injuries and treatment outcome were analyzed.

Results: The mean age of the 39 patients in this study was 30.5yrs ± 7.9 SD with a male: female ratio of 6.8:1. Inflicted cut throat injuries accounted for 46% followed by vehicular accidents in 21%. Zone II site of the neck was the commonest site of injury 61.6% of the patients; while 71.8% of the patients presented within 24hrs of the injury, 46% of them had immediate blood transfusion. Tracheostomy was the main method of securing the airway. Primary soft tissue repair was performed on all the patients. Laryngopharyngeal repair was done in 61.5%. Peri-operative mortality was 7.7% and 83.3% had prolonged hospital admission with wound infection in 27.8% and laryngotracheal stenosis in 22.2% as the commonest complications.

Conclusion: This study has shown that penetrating anterior neck injuries is not uncommon in Nigeria and commonly due to cut throat and vehicular accidents. Proper documentation and following established management protocols will improve outcome.