Since Ambrose Pare's successful treatment of a penetrating neck wound in 1552, the surgical management of cervical injury has become a necessary skill for the practicing surgeon. Because penetrating trauma to the neck is common, the surgeon must be intimately familiar with options for operative approach, control and repair. Neck injury is considerably challenging due to the high density of critical structures crowded into this narrow cervical conduit. A multitude of organ systems are susceptible to injury and a delay in treatment can be fatal. Exposure can be unnerving, particularly with the aerodigestive tracts, and a detailed knowledge of neck anatomy is necessary to manage these insults. This video demonstrates the feasibility of prompt and definitive surgical intervention to minimize the adverse sequelae of this morbid injury.

Included in this video is a review of the necessary operative preparation and positioning, a detailed discussion of neck anatomy, as well as the exposures and repairs necessary to manage cervical vascular, esophageal and tracheal injuries. Strap muscle interposition for tracheal repair is just some of the techniques described. The approaches and maneuvers demonstrated in this video should allow for salvage of many patients with these formidable injuries.