Patterns of injury and otolaryngology intervention in pediatric neck trauma

Neck trauma in the pediatric population is relatively rare with limited discussion in the literature describing the injury patterns and outcomes of all neck trauma victims. This study characterizes pediatric neck trauma both inside and outside the context of injuries requiring otolaryngology (ENT) intervention.

Patients sustaining neck trauma presenting to a single tertiary care hospital between January 2001 and June 2010 were included. Demographic information was obtained in addition to information regarding the initial hospital stay and follow up visits related to the initial trauma.

Seventy-four patients were included. Blunt injuries were found in 44 children with 30 sustaining penetrating injuries. Twenty-eight percent of patients had an ENT consultation. Those patients with injuries warranting ENT consultation were nearly 3 times more likely to require intubation than those without an ENT consultation (p=0.009). Laryngotracheal injuries were documented in 11 patients with 6 of these characterized as major injuries and 5 minor injuries.

Pediatric neck trauma represents a spectrum of injuries from ecchymosis to major laryngotracheal injury. Otolaryngology involvement is not necessary in all cases; however, one must be aware of the risk of laryngotracheal injury, particularly with blunt trauma and there should be a low threshold for Otolaryngology consultation and endoscopy.