| Abstract: | Airway management is of primary concern in many patients with major penetrating or blunt trauma, particularly injury to the cervical trachea. Although such an injury is infrequent, it is an immediate threat to life and, if unrecognized, can lead to both early and delayed complications. Among more than 700 patients with major neck trauma seen during the past twenty-seven years at the Ben Taub General and Jefferson Davis Hospitals in Houston, Texas, sixty-five patients had injuries to the cervical trachea. In four, the injury extended to include the intrathoracic trachea and/ or main stem bronchus. The most severe injuries occurred in patients with blunt trauma, two requiring emergency cardiopulmonary bypass to accomplish extensive tracheobronchial repair. Tracheostomy was almost always employed. There were no operative deaths attributable to the tracheal injuries themselves. Early control of the airway, assessment of associated injuries, and employment of indicated adjunctive measures provided for successful management of these uncommon injuries. |
