title: An evidence based review of the assessment and management of penetrating neck trauma.
abstract: BACKGROUND
  Although relatively uncommon, penetrating neck trauma has the potential for serious morbidity and an estimated mortality of up to 6%. The assessment and management of patients who have sustained a penetrating neck injury has historically been an issue surrounded by significant controversy. OBJECTIVES OF REVIEW: To assess recent evidence relating to the assessment and management of penetrating neck trauma, highlighting areas of controversy with an overall aim of formulating clinical guidelines according to a care pathway format.
  
  
  METHODS
  Structured, non-systematic review of recent medical literature.
  
  
  METHODS
  An electronic literature search was performed in May 2011. The Medline database was searched using the Medical Subject Headings terms 'neck injuries' and 'wounds, penetrating' in conjunction with the terms 'assessment' or 'management'. Embase was searched with the terms 'penetrating trauma' and 'neck injury', also in conjunction with the terms 'assessment' and 'management'. Results were limited to articles published in English from 1990 to the present day.
  
  
  METHODS
  Abstracts were reviewed by the first three authors to select full-text articles for further critical appraisal. The references and citation links of these articles were hand-searched to identify further articles of relevance.
  
  
  RESULTS
  147 relevant articles were identified by the electronic literature search, comprising case series, case reports and reviews. 33 were initially selected for further evaluation.
  
  
  CONCLUSIONS
  Although controversy continues to surround the management of penetrating neck trauma, the role of selective non-operative management and the utility of CT angiography to investigate potential vascular injuries appears to be increasingly accepted.
authors.affiliation: Department of ENT Surgery, The Royal Berkshire Hospital, Reading, UK. chris.burgess@doctors.org.uk
authors.forename: C A
authors.initials: CA
authors.lastname: Burgess
authors.forename: O T
authors.initials: OT
authors.lastname: Dale
authors.forename: R
authors.initials: R
authors.lastname: Almeyda
authors.forename: R J
authors.initials: RJ
authors.lastname: Corbridge
mesh_terms: D003952:Diagnostic Imaging / Q000379:methods*; D019468:Disease Management; D014943:Global Health; D006801:Humans; D009017:Morbidity / Q000639:trends; D019838:Neck Injuries / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D015996:Survival Rate / Q000639:trends; D015599:Trauma Severity Indices; D014950:Wounds, Penetrating / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy