Ultra-low Velocity Penetrating Neck Trauma: Explore/Extract?

Objective: 1) Describe the injury pattern caused by ultra-low velocity (ULV) foreign body penetration of the neck in the context of self-mutilation, and 2) Propose a conservative management strategy for removal of such foreign bodies when the likelihood of serious injury is low.Method: Case series of 8 incidents of self-inflicted ULV penetrating neck trauma in a single patient who presented to a tertiary care hospital between December 2007 and December 2008. Postoperative morbidity was analyzed according to the presenting signs, symptoms, and radiologic findings and to the extent of surgical intervention.Results: Ten foreign bodies were removed on 8 separate occasions. Concerning physical signs were present on one occasion (bleeding); symptoms on 3 (dyspnea or odynophagia); and radiologic findings on 6. Seven objects were retrieved by targeted dissection, with a mean operative time of 27.7 ± 8.4 min. Three objects were removed in the context of formal neck exploration, each with an operative time of 65 mi...