Penetrating Neck Trauma

Annotation for Point D

Zone I patients without indications for neck exploration should undergo CTA of the chest and neck to evaluate for both vascular and aerodigestive injuries. Initially, CTA was primarily considered for its ability to detect vascular injury, but more recent series have demonstrated a high sensitivity for detecting aerodigestive tract injuries.15,17 No specific literature focuses on the management of Zone I penetrating injuries, but owing to the more difficult surgical exposure options and growing endovascular techniques available that may benefit the stable patient with vascular injury, a road map provided by CTA, which characterizes the location and extent of a vascular injury and demonstrates the trajectory or tract of the wound for potential aerodigestive injury, is invaluable for the management planning.23