Binky Bites and Other Oronasal Pressure Injuries
Related Experiment Videos
Louisa B Mook1, James B Metz1, Stephen C Boos2
1From the Seattle Children's Hospital, Seattle, WA.
Insights
Child abuse can cause severe nasal injuries, sometimes mimicking other conditions. This study highlights rare cases of nasal destruction from forced pacifier or gag use in abused children.
Area of Science:
- Pediatrics
- Forensic Medicine
- Child Abuse Research
Background:
- Childhood injuries require careful evaluation to rule out abuse.
- Oronasal injuries from abuse are documented, but nasal destruction is uncommon.
Observation:
- This study details four pediatric cases with significant nasal tissue destruction.
- Two cases involved injuries from forced pacifier insertion.
- Two cases involved injuries associated with gag use.
Findings:
- Abusive implements, including pacifiers and gags, can cause severe nasal trauma.
- Nasal destruction is a rare but serious indicator of physical abuse and neglect.
- All four children exhibited additional signs of abuse and neglect.
Implications:
- Clinicians should consider physical abuse in cases of unexplained nasal trauma.
- Forensic evaluation is crucial for identifying abusive mechanisms in pediatric injuries.
- Early recognition and intervention are vital for protecting child victims of abuse.
Abstract:
Initial examination and exploration of childhood injuries may not lead to an obvious explanation of abuse. Although abusive oronasal injuries have been described, ones including nasal destruction are rare. We describe 4 children abused using implements that ultimately were thought to have caused significant nasal tissue destruction. In 2 of the cases, a forced pacifier placement was implicated in causing pressure injuries. In the other 2 cases, gags were part of the children's injuries. All 4 children had other findings of abuse and neglect.