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visualization or surgical intervention may be required When acute airway management is not a concern, the aim is to identify which patient with minimal or no symptoms warrants advanced imaging and/or surgical consultation to avoid missing injuries to these critical structures that have the potential to progress (see Chapter 112 Neck Trauma for further details) CLINICAL PEARLS AND PITFALLS Patients with blunt trauma to the anterior neck should also be evaluated for cervical spine injury Any patients with penetrating injuries to the central third (i.e., zone 2) of the neck should be considered for surgical exploration even if stable Patients with penetrating injuries to zones and of the neck should initially undergo MRA/MRV to assess for vascular injury prior to other interventions including exploration Current Evidence Blunt trauma can cause mucosal lacerations, hematomas, vocal cord injury, or fractures of the bony or cartilaginous larynx and trachea Penetrating trauma results in additional risk to the airway and vasculature, as covered in Chapter 112 Neck Trauma Clinical Considerations Clinical Recognition Blunt injuries to the neck often present with neck pain, hoarseness, cough, or hemoptysis Some patients may have relatively mild symptoms despite injury Neck swelling, or visible injury such as ecchymosis and abrasions may be identified on examination Triage Patients with significant respiratory distress or penetrating injuries to the neck should be emergently evaluated and surgical specialty consultation pursued Those without acute compromise of the airway, breathing, or circulation should be seen expeditiously and monitored frequently for clinical deterioration