固定式三点シートベルトによる頚部開放性損傷の１例

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  • Open Neck Injury by a Three Point Seat Belt.

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A 34-year-old woman with an open neck injury after automobile accident was transferred to the emergency center. When she hit an anterior portion of her neck, she was sitting next to the driver with a three point seat belt on. An open neck wound was found in the anterior upper left to lower right part of her neck. The airway was defect in the subglottic portion of the trachea.<BR>Emergency surgery was performed after an endotracheal tube was inserted through the mouth with a fiberoptic scope under NLA. The defect of the subglottic portion of the larynx was covered with a pedicled sternocleidomastoid muscle and a tracheostomy was made. Hoarseness appeared on the 10th postoperative day (10 POD). Inflammatory granulation tissue was found in the place where anterior the wall was repaired with local muscle flap. On the 26 postoperative day, she was dischrged without any hoarseness or dyspnea.<BR>Following points were thought to be important; 1. Insertion of the endotracheal tube under NLA to prevent an iatrogenic occlusion of the airway by the cuff. 2. Tracheostomy is useful for better wound healing. 3. Use of local muscle flap and meticulous handling of the cricoid cartilage. 4. Seat belts sometimes make various types of neck injuries.

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