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Maxillofacial and otolaryngology/head and neck surgery health-care professionals play a vital role in field hospitals due to their expertise in caring for acute trauma care patients and treating emergent life-threatening conditions; that is, airway injuries and head and neck infections. In this chapter, we review common conditions and injuries treated by this team. The large volume of the expected patients presenting with various related conditions make the presence of the otolaryngologist/head and neck surgeon extremely valuable.
This chapter discusses the diagnosis, evaluation and management of neck trauma. It presents special considerations with regard to immobilization and the safety of removing the cervical collar for penetrating neck trauma. High-resolution computed tomography angiography (CTA) is the initial diagnostic study of choice in the stable patient with penetrating neck trauma or blunt neck trauma when blunt cerebrovascular injury is suspected. CTA can be the initial diagnostic study of choice regardless of zone of injury. CTA is particularly useful for zone I and III penetrating injuries, which are more difficult to evaluate by physical examination. Unstable patients with penetrating injuries require immediate surgical consultation and exploration in the OR. Unstable patients include those patients with hard signs: clear airway injury (air bubbling through wound), hemodynamic instability despite resuscitation, uncontrolled bleeding (including expanding hematoma), or evolving neurological deficit.
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