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Penetrating craniofacial injury in a pediatric patient
Khalid Al-Sebeih1, Kostadin Karagiozov, Abdulmohsen Jafar
1Department of Surgery-Otolaryngology Division, Faculty of Medicine, Kuwait University, PO Box 17228 khalidiya, 72453 Kuwait. kalseb66@yahoo.com
Insights
A rare pediatric craniofacial injury involved a TV antenna penetrating a child
Area of Science:
- Pediatric Traumatology
- Neurosurgery
- Otolaryngology
Background:
- Penetrating craniofacial injuries are uncommon in children.
- These injuries pose significant diagnostic and management challenges due to potential life-threatening complications.
Observation:
- A 30-month-old child sustained a severe craniofacial injury from a TV antenna.
- Radiological imaging revealed the antenna traversed the hard palate, nasal choana, sphenoid sinus, and skull base, reaching the pituitary fossa.
- Cerebral angiography excluded injury to major cerebral vessels.
Findings:
- Surgical removal of the antenna via a transpalatal approach was successful.
- Skull base defect repair was performed concurrently.
- Postoperative assessment showed no neurological or visual deficits.
Implications:
- This case highlights the possibility of unusual foreign body penetration in pediatric craniofacial trauma.
- Prompt surgical intervention and multidisciplinary care are crucial for favorable outcomes.
- Management of potential endocrine complications, such as diabetes insipidus, is essential.
Abstract:
Penetrating craniofacial injuries are rare especially in the pediatric age group. They are potentially life-threatening and challenging injuries. We describe an unusual trauma in a 30-month-old child who suffered a craniofacial injury caused by TV antenna. Clinical examination and radiological investigation showed the antenna penetrating the hard palate, left posterior nasal choana, sphenoid sinus, and skull base, up to pituitary fossa. There was no evidence of great vessels injury that confirmed by cerebral angiography. Transpalatal approach was used to remove the antenna and repair the skull base defect. There was no neurological or visual activity deficit postoperatively. The child developed diabetes insipidus that is well controlled using desmopressin.