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Incidence of morbidity from penetrating palate trauma

Kara Hennelly1, Amir Kimia, Lois Lee

  • 1Division of Emergency Medicine, Children's Hospital Boston, 300 Longwood Ave, Boston, MA 02115, USA. kara.hennelly@childrens.harvard.edu

Pediatrics
|November 3, 2010
PubMed

Insights

Penetrating palatal trauma in children rarely causes stroke or infection. Diagnostic imaging in the emergency department (ED) for these injuries did not lead to interventions beyond antibiotics.

Area of Science:

  • Pediatric Emergency Medicine
  • Pediatric Traumatology
  • Pediatric Neurology

Background:

  • The incidence of neurologic sequelae and infection following penetrating palatal trauma in children remains poorly defined.
  • This uncertainty contributes to variability in diagnostic and treatment approaches for pediatric palatal injuries.

Purpose of the Study:

  • To ascertain the incidence of stroke and infection in well-appearing children with penetrating palatal trauma.
  • To characterize the diagnostic and treatment patterns for uncomplicated palatal trauma in pediatric patients.

Main Methods:

  • A retrospective cohort study was conducted on children (9 months to 18 years) presenting to a tertiary care pediatric hospital's emergency department (ED) with palatal trauma.
  • Inclusion criteria included: well-appearing, normal neurologic examination, palatal laceration without need for immediate surgery. Stroke was defined as trauma-related abnormal neurologic findings; infection as cellulitis or abscess.
  • Computed tomographic angiography (CTA) findings, excluding free air, were considered positive if abnormal.

Main Results:

  • Of 205 eligible children, stroke incidence was 0% (95% CI: 0-2.5%).
  • One child developed infection (0.9% incidence, 95% CI: 0-5.3%).
  • Forty-four percent of patients underwent CTA, with 10% showing positive findings; none required operative intervention. No patients received anticoagulants.

Conclusions:

  • Morbidity from penetrating palatal trauma in well-appearing children is exceptionally low.
  • Emergency department evaluations for these injuries seldom resulted in interventions beyond antibiotic prescription.
Abstract

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