Outcomes in pediatric patients with recreational vehicle related forceful head impact
Cameron C Sheehan1, Meredith Lind2, Justin B Mahida3
1The Ohio State University College of Medicine, Nationwide Children's Hospital, Columbus, OH, United States.
Insights
Recreational vehicle accidents pose a higher risk of otic capsule violation and hearing loss in children with head injuries, even with protective gear. Helmets do not fully protect the temporal bone, increasing the risk of long-term hearing consequences.
Area of Science:
- Trauma surgery
- Otolaryngology
- Pediatric emergency medicine
Background:
- Forceful head impacts in children can lead to severe injuries.
- Recreational vehicle (RV) use is a common cause of pediatric trauma.
- Understanding injury patterns is crucial for effective treatment and prevention.
Purpose of the Study:
- To compare outcomes of forceful head impacts in pediatric patients from recreational vehicle use versus other mechanisms.
- To identify specific risks associated with recreational vehicle-related head trauma.
Main Methods:
- Retrospective cohort study of patients aged 3-18 years.
- Inclusion criteria: forceful head impact (resulting in face or skull fracture).
- Data collected from institutional trauma registry (January 2011 - September 2013).
Main Results:
- 64 of 252 forceful head impacts involved recreational vehicles.
- Recreational vehicle accidents showed higher rates of otic capsule violation (21% vs. 5%) and hearing loss (30% vs. 16%).
- Otic capsule violation and sensorineural hearing loss in RV accidents were linked to temporal bone fractures.
Conclusions:
- Recreational vehicle use increases the risk of temporal bone fractures and subsequent hearing loss in pediatric patients.
- Current head protective gear for recreational vehicles does not adequately protect the temporal bone.
- Otolaryngologists must consider the heightened risk of otic capsule injury and hearing loss in these patients.
Purpose:
To compare outcomes in pediatric patients suffering forceful head impact during recreational vehicle use to patients with forceful head impact from other mechanisms.
Methods:
Retrospective cohort study of all patients 3-18 years old who suffered forceful head impact (any traumatic mechanism strong enough to result in a face or skull fracture) in our institutional trauma registry between January 2011 and September 2013.
Results:
Out of 252 events involving forceful head impact, 64 events were a result of riding a recreational vehicle. Although there is no difference in rates of temporal bone fractures, recreational vehicle accidents have higher rates of otic capsule violation (21% vs. 5%) and higher rates of hearing loss (30% vs 16%) compared to patients with forceful head impact from other mechanisms. All incidents of otic capsule violation and sensorineural hearing loss in recreational vehicle accidents were associated with a temporal bone fracture.
Conclusion:
Despite the increasing use of head protective gear while operating a recreational motor vehicle there is still heightened risk for temporal bone fractures and subsequent hearing loss. The comparative associations in this study suggest that helmets used with recreational vehicles do not protect the temporal bone thus leaving vital structures within the otic capsule at risk for damage and long term consequences. When treating these patients Otolaryngologists should be aware of the elevated risk of otic capsule violation and late hearing loss with temporal bone fractures.
