Resident Manual of Trauma to the Face, Head and Neck

G. Cricotracheal (Laryngotracheal) Separation.......................... 185 H. Emergency Airway Management............................................. 185 I. Selection of Airway Stents and Tracheotomy Tubes............186 1. Airway Stents...........................................................................186 2. Tracheotomy Tubes................................................................186 VII. Summary ...............................................................................................186 VIII. References ............................................................................................ 187 Chapter 9: Soft Tissue Injuries of the Face, Head, and Neck .............188 I. Physical Examination .........................................................................188 A. Perform Complete Head and Neck Exam at Presentation.... 189 1. Eyes............................................................................................. 189 2. Ears............................................................................................. 189 3. Nose............................................................................................ 189 4. Mouth......................................................................................... 189 5. Neck............................................................................................ 189 6. Scalp........................................................................................... 189 7. Cranial Nerves..........................................................................190 II. Diagnosis, Imaging Studies, and Laboratory Assessment .....190 A. Diagnosis.........................................................................................190 B. Imaging Studies.............................................................................190 1. Plain Film Radiographs...........................................................190 2. Computed Tomography (CT)...............................................190 3. Magnetic Resonance Imaging and Ultrasonography......191 C. Laboratory Assessment................................................................191 1. Complete Blood Count............................................................191 2. Chemistries................................................................................191 3. Toxicology..................................................................................191 III. Surgical Decision-Making Principles .............................................191 A. Timing of Wound Repair..............................................................191 1. Primary Closure........................................................................191 2. Delayed Primary Closure........................................................191 3. Closure by Secondary Intent................................................ 192 4. Adjunctive Therapies............................................................. 192 5. Post-Healing............................................................................. 192 B. Anesthesia Considerations......................................................... 192 1. Localized Tissue Injuries........................................................ 192 2. Extensive Injuries..................................................................... 193 C. Irrigation and Debridement........................................................ 193 1. Microdebridement..................................................................194 2. Macrodebridement.................................................................194

11

www.entnet.org