Penetrating Neck Injuries from Firearms Accompanied by Laryngeal Injuries, Two Case Studies.

Introduction: Penetrating neck injuries (PNIs) from firearms are life-threatening emergencies due to the risk of airway compromise and major hemorrhage. Laryngeal trauma, though uncommon, adds further complexity and can be fatal without prompt intervention. Case Presentations: Case 1: A 44-year-old male sustained a gunshot wound to the anterior neck. Imaging revealed fractures and displacement of the right thyroid cartilage, soft tissue hematomas, and subcutaneous emphysema, with an exit wound in the left submandibular area. The patient exhibited stridor, dysphonia, and active bleeding. Emergency airway stabilization and surgical repair led to a full recovery of respiratory and vocal function. Case 2: A 40-year-old male presented with a trans-neck gunshot wound exiting through the left scapulohumeral region. He had associated clavicular and humeral fractures and signs of hemorrhagic shock. Immediate airway management via intubation and tracheostomy, along with hemodynamic stabilization, resulted in a favorable outcome after 14 days in intensive care. Successful management of PNIs involving the larynx necessitates a rapid, multidisciplinary approach. Imaging, airway protection, and timely surgical intervention are crucial for preserving laryngeal function. Conclusion: Firearm-related PNIs with laryngeal involvement demand immediate, coordinated care. These cases highlight the importance of early airway control, accurate diagnosis, and surgical expertise in optimizing outcomes and preserving vital functions.