What are the three anatomical levels of the neck?
Zone 1 - from clavicles/sternal notch to the cricoid cartilage; Zone 2 - from cricoid cartilage to the angle of the mandible; Zone 3 - from the angle of the mandible to the base of the skull
Wound track extends from a skin defect in the right anterolateral neck, through platysma and the substance of the sternocleidomastoid muscle, which is thickened and contains clot and gas locules.
The wound tract terminates superficial to the lateral aspect of the mid pole of the right lobe of thyroid, immediately superficial to the distal common carotid artery and internal jugular vein.
Gas locules track along the facial planes deep to the sternocleidomastoid, sternohyoid and sternothyroid muscles.
Conclusion:
- Penetrating injury of the right anterolateral neck traverses platysma and the sternocleidomastoid muscle but terminates superficial to the thyroid gland, carotid artery and internal jugular vein, with no evidence of vascular injury.