Multidisciplinary Therapeutic Management in Complex Cervical Trauma

• Published in: Medicina
• Main Authors: Florentina Severin, Andrei-Mihail Rosu, Mirela Tiglis, Laura-Elisabeta Checherita, Gina Stegaru, Mihail Dan Cobzeanu, Razvan Hainarosie, Bogdan Mihail Cobzeanu, Octavian Dragos Palade
• Format: Article
• Language: English
• Published: MDPI AG 2023-03-01
• Subjects: otorhinolaryngology; surgery; multidisciplinary treatment; complex cervical trauma
• Online Access: https://www.mdpi.com/1648-9144/59/3/596
• ISSN: 1010-660X; 1648-9144

<i>Background and Objectives</i>: In the current literature, mandatory surgical exploration is a controversial topic, with some advocating for it and others against it, proposing a selective conservative management. This multidisciplinary therapeutic approach is based on clinical examination and serial paraclinical explorations associated with supportive drug treatment. <i>Materials and Methods</i>: The study group consisted of 103 patients with complex cervical trauma pathology produced by various mechanisms such as car or domestic accidents, aggression, ballistic trauma, self-inflicted attempts, hanging or strangulation hospitalized in the Ear, Nose and Throat (E.N.T.) Clinic, at “St. Spiridon” Iași Hospital, between 2012 and 2016. <i>Results</i>: The universal clinical indication for urgent surgical exploration of the patient with complex cervical trauma is the presence of the following symptoms: unstable vital signs, significant pulsatile bleeding, hematoma with a substantial increase in size, shock, airway obstruction, open airway wound, hematemesis, or hemoptysis. In this context, we considered it worthwhile to research the management of complex cervical trauma in a reference university medical center, alongside the analysis of the patient’s characteristics under different aspects (demographic, pathological aspects, therapeutic). <i>Conclusions</i>: Complex cervical trauma has a variety of clinical aspects, with a variable evolution, which involves multidisciplinary therapeutic management. The increasing trauma rate is one of the main public health problems, requiring epidemiological studies, and the implementation of control strategies.