DOI: 10.14260/jemds/2015/953 ORIGINAL ARTICLE J of Evolution of Med and Dent Sci/ eISSN- 2278-4802, pISSN- 2278-4748/ Vol. 4/ Issue 38/ May 11, 2015 Page 6572 CUT THROAT INJURIES AND IT MANAGEMENT: A CLINICAL STUDY OF 48 PATIENTS Md. Naveed Ahmed 1 , M. Sreedhar Rao 2 , S. Muneeruddin Ahmed 3 , M. Mahendra Kumar 4 HOW TO CITE THIS ARTICLE: Md. Naveed Ahmed, M. Sreedhar Rao, S. Muneeruddin Ahmed, M. Mahendra Kumar. DzCut Throat Injuries and it Management: A Clinical Study of 48 Patientsdz. Journal of Evolution of Medical and Dental Sciences 2015; Vol. 4, Issue 38, May 11; Page: 6572-6581, DOI: 10.14260/jemds/2015/953 ABSTRACT: INTRODUCTION: Cut throat injuries are one of the emergency conditions managed by E. N. T. specialists. They are clinically interesting and pose a challenge to the surgeon in the management. Six out of the ten cut throat injuries treated at casualty department are homicidal in nature. Such injuries can involve any part of the upper airway from the supra hyoid region to upper trachea. Commonest site of involvement in our series was between thyroid cartilage and cricoid cartilage. Initial management was done by securing the airway with preliminary tracheostomy below the cut in the neck and introducing a cuffed tracheostomy tube of appropriate size. Thorough exploration of the wound to note other vascular or neural injuries and injuries to esophagus was carried out. Initial management consisted of Correction of hypovolaemia, ligation of the bleeding vessels and primary repair of the wound in layers. The cut edges of the pre laryngeal and pre tracheal muscles are identified and sutured to strengthen the gap between the cartilages. The mortality is low if the treatment protocols are followed meticulously. MATERIALS AND METHODS: 48 Patients presenting with cut throat injuries at the casualty are taken for the study. 28 cases are homicidal, 14 are homicidal and 3 are accidental and 3 are road traffic accidents. All the injuries are open variety. They are examined, resuscitated and treated by primary suture. The data is classified and analyzed, depending upon level of the cut injury in the airway, the length and depth of the cut injury. The important structures damaged involvement of air and food passages. Is observed and recorded. Complications during the management are analyzed and treated. OBSERVATION: The cause of injury is homicidal, suicidal and RTA in nature. All the cut throat injuries encountered in this study are open variety. Complications included mediastinal emphysema, hypovolemic shock, wound dehiscence and laryngo-tracheal stenosis. Survival rate is improved by prompt treatment DISCUSSION: As all the cut throat injuries presented airway compromise we managed the patients by securing the airway by tracheostomy below the level of injury to airway. Apart from providing airway, this would give rest to the site of injury & avoid aspiration. Hypovolaemia was corrected with volume expanders and blood transfusion. After initial management patients were shifted to the operation theatre. Most of the patients were managed under General Anesthesia. Tracheostomy provided the route for administration of General Anesthesia. Wound debridement was done as most of the cases presented more than 6 to 8 hrs from the time of injury. Exploration of the wound was done to identify vascular or neural damage and treated accordingly. RESULTS: In the present study mortality rate is 10%. Complications are managed by conservative methods. Two patients required laryngeal and tracheal stents to correct stenosis. KEYWORDS: Neck injuries, Hyoid, Thyroid, Cricoid, Cricothyroid, Trachea, Esophageal perforation, Pneumothorax, tracheal stenosis.