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Basilar skull fractures in children
1Department of Otorhinolaryngology--Head and Neck Surgery, Los Angeles County/University of Southern California Medical Center.
Insights
Pediatric basilar skull fractures are often caused by vehicle accidents or falls. Common signs include ear bleeding and hearing loss, with diagnosis confirmed by radiography.
Area of Science:
- Pediatric Traumatology
- Neurosurgery
- Emergency Medicine
Background:
- Basilar skull fractures are serious injuries in children.
- Understanding pediatric basilar skull fracture epidemiology is crucial for prevention and management.
Purpose of the Study:
- To analyze the etiology, clinical presentation, diagnosis, and outcomes of basilar skull fractures in pediatric patients.
- To provide insights into the management of pediatric basilar skull fractures.
Main Methods:
- Retrospective study of pediatric patients (<18 years) diagnosed with basilar skull fracture.
- Data collected from January 1979 to December 1987 at a major medical center.
- Analysis of patient demographics, injury mechanisms, clinical findings, diagnostic methods, and complications.
Main Results:
- Sixty-two pediatric patients were identified.
- Pedestrian versus vehicle accidents (42%) were the most common cause, followed by falls (27%).
- Key findings included hemotympanum (58%), ear canal bleeding (47%), and hearing loss (34%). Cerebrospinal fluid otorrhea occurred in 26%.
Conclusions:
- Basilar skull fractures in children result from significant trauma, frequently involving vehicles.
- Early identification of clinical signs and prompt radiographic confirmation are essential for effective management.
- This study highlights the importance of understanding injury patterns and clinical manifestations for improved pediatric trauma care.
Abstract:
In this paper we are reporting a retrospective study of patients under 18 years of age managed at the Los Angeles County/University of Southern California Medical Center from January 1979 through December 1987 with the diagnosis of basilar skull fracture. Sixty-two patients with basilar skull fractures were admitted during that 7 1/2 year period. The most common etiology was pedestrain versus vehicle accidents (42%), followed by falls (27%), vehicle accidents (23%), and being hit by an object (8%). The most common physical findings were hemotympanum (58%) and bleeding in the ear canals (47%). Thirty-four percent of the patients complained of hearing loss. Cerebrospinal fluid otorrhea was noted in 16 patients (26%), while only 1 patient had cerebrospinal fluid rhinorrhea. Facial nerve paralysis was present in 8 patients (13%). Vestibular symptoms were rare. Sixty-three percent of the patients had the diagnosis confirmed by radiography. The clinical presentation, complications, management and outcome of basilar skull fractures in the pediatric population are discussed.