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Evaluation of pediatric lateral oropharyngeal trauma
Daniel J Ratcliff1, Pamela J Okada, Alan D Murray
1Department of Otoraryngology-Head and neck Surgery and Pediatrics, University of Texas-Southwestern Medical Center, Dallas, TX 75390-9035, USA.
Insights
Children with lateral oropharyngeal trauma require careful evaluation. Contrast-enhanced computed tomography can effectively screen for internal carotid artery injuries, guiding further angiography and observation.
Area of Science:
- Pediatric Emergency Medicine
- Trauma Surgery
- Vascular Imaging
Background:
- Lateral oropharyngeal trauma in children can pose a risk to the internal carotid artery.
- Prompt and accurate diagnosis is crucial for preventing neurovascular compromise.
Purpose of the Study:
- To review the mechanism of injury, presentation, and evaluation of children with lateral oropharyngeal trauma.
- To assess the utility of imaging modalities in identifying internal carotid artery injuries.
Main Methods:
- Retrospective review of pediatric patients with lateral oropharyngeal trauma over a 5-year period.
- Analysis of patient demographics, injury mechanisms, clinical examinations, and imaging findings.
Main Results:
- Forty-eight patients with lateral oropharyngeal injuries were identified.
- Computed tomography identified carotid abnormalities in 3 of 14 patients, with angiography confirming intimal injuries in 2.
- No cases of neurovascular compromise were reported.
Conclusions:
- Contrast-enhanced computed tomography is a potentially effective screening tool for children with lateral oropharyngeal trauma.
- This imaging modality can help identify patients who require further angiography and observation for internal carotid artery injuries.
Objective:
We reviewed the mechanism of injury, presentation, and evaluation of children with trauma to the lateral oropharynx. Study design and setting We conducted a retrospective review of patients in an urban pediatric emergency department with trauma to the lateral oropharynx over a 5-year period.
Results:
Forty-eight patients were identified with documented injuries of the lateral oropharynx placing the internal carotid artery at risk of injury. The average age was 42 months, with a male-to-female ratio of 1.5:1. Seventy-seven percent of patients had a documented neurologic examination. Examinations were normal in all cases. Computed tomography scans were obtained in 14 patients, identifying 3 patients with carotid abnormalities. Angiography subsequently diagnosed intimal injuries in 2 of the 3 patients. There were no known cases of neurovascular compromise.
Conclusion:
Contrast-enhanced computed tomography may be an effective screening examination in this patient population, helping to determine which children should be admitted for angiography and observation.