Throat injuries: Causes, Symptoms, Treatment, Diagnosis

Any penetrating trauma or blunt trauma to the throat can result in a throat injury.

Major arteries and veins pass through the throat. Therefore, any trauma which results in the break in the skin can do extensive damage. This can lead to severe bleeding.

Throat injury can be due to different types of external forces and may vary in degree from mild bruising to damage to the nerves, trachea or even the bones of the neck.

Blunt trauma to the throat can injure the trachea, esophagus, spine, or even the brain stem. Injury to trachea can result in difficulty in breathing, swallowing, or hoarseness of the throat. If the vocal cord is injured there may be difficulty in the speaking, hoarse throat, or even complete lack of ability to speak. A blunt trauma resulting in damage to the cervical spine can cause difficulty in moving the neck.

There are many important and delicate structures inside the small space of the throat. The injuries to throat, be it blunt or penetrating, can cause some level of damage to them.

The throat is not protected by any bony cartilage and is open to injury or trauma, the different causes of throat injuries are,

Sports injury: It can result in being struck by another player’s extremity, helmet or any sports equipment.

Automobile injury: Being struck by an automobile and injured by any blunt object or cut by a metal or a glass.

Being punched or kicked in the throat.

Gunshot wounds: This is a penetrating injury.

Accidental fall on a sharp or a blunt object.

More men than women are at risk of throat injuries as they engage more in high-risk behavior such as fast driving, reckless driving, high-risk sports such as boxing and football. Also, people who practice martial arts are at higher risk of sustaining throat injury.

Symptoms of the throat injury depend on the structure in the throat injured. The various structures are thyroid gland, major blood vessels and nerves, the trachea, the esophagus, and the cervical spine.

The symptoms presented by the patient who has injured the throat may be,

1. Difficulty in swallowing
2. Hoarseness
3. Stridor
4. A sensation of fullness in the throat
5. Spitting up of blood
6. Labored breathing
7. Bleeding in the mouth
8. Swelling in throat
9. Subcutaneous air

If there is bleeding from a laceration or the punctured wound, there can be involvement of a major artery. An angiogram is done to assess the carotid artery and the jugular vein.

In case of pain in the cervical region, the area is immobilized and an X-ray is done to rule out any major injury. An orthopedic is involved if there is any bone injury seen in the X-ray.

Laryngoscopy is done to visualize the vocal cords to look for any fracture, dislocation or swelling due to trauma. It is mostly done in case of hoarseness of voice after an injury.

MRI or CT scan are performed to see the internal structures of the head and neck.

First of all, follow the first aid measure as these situations can go bad very quickly. The first aids steps are as follow,

• Call an emergency as soon as possible.
• Till the emergency medical service arrive, make the person sit in an upright position to minimize the blood flow to the area.
• To open the airway bend the head back.
• If the patient stops breathing, do the rescue breathing immediately. Check the breathing periodically.
• Apply direct, continuous pressure at the bleeding site.
• Immobilize the cervical region
• Put an ice pack to reduce swelling
• In case the person vomits, roll him to a side so that he does not choke the airway.
• If signs of shock are present, elevate the legs and keep the patient warm.
• Monitor the patient until the medical help arrives

After the medical help arrives, the patient’s blood pressure is stabilized through IV (intravenous drip). Assessment and management of the injured area are done.

Cricothyrotomy, a hole in the neck is done to create an airway if the airway above it is occluded.

After breathing is controlled, the doctor manages the bleeding by applying ice or direct pressure.

In the case of cervical bone injury, surgery to fuse the bony segments is performed.