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Systematic Review of CT Angiography in Guiding Management in Pediatric Oropharyngeal Trauma

Steven D Curry1, Dallin N Christensen1, Pooja M Varman2

  • 1Department of Otolaryngology - Head and Neck Surgery, University of Nebraska Medical Center, Omaha, Nebraska, USA.

The Laryngoscope
|May 13, 2022
PubMed

Insights

Computed tomography angiography (CTA) rarely changes diagnosis or treatment for pediatric oropharyngeal trauma. This study suggests routine CTA is not recommended due to radiation risks and limited impact on patient outcomes.

Area of Science:

  • Pediatric Traumatology
  • Vascular Imaging
  • Neurovascular Sequelae

Background:

  • Pediatric oropharyngeal trauma can lead to severe internal carotid artery injuries.
  • The use of CT angiography (CTA) in evaluating these injuries is controversial.
  • There is a need to assess the diagnostic and therapeutic utility of CTA in this population.

Purpose of the Study:

  • To evaluate changes in diagnosis and treatment for pediatric oropharyngeal trauma based on CT angiography findings.
  • To determine the clinical significance of CTA in identifying carotid artery injuries in children.
  • To appraise the impact of CTA on patient management and outcomes.

Main Methods:

  • A systematic literature review was conducted following PRISMA guidelines.
  • Databases searched included PubMed, Embase, CINAHL, Scopus, and clinical trial registries.
  • Included studies focused on pediatric patients with oropharyngeal trauma who underwent CTA.

Main Results:

  • Eight articles involving 662 patients were included; 255 had CTA.
  • Eleven carotid abnormalities were detected on CTA (edema, intimal tear, spasm, compression).
  • The pooled proportion of CTA findings leading to management changes was 0.00 (95% CI 0.00-0.43); angiography confirmed rare abnormalities without significant clinical impact.

Conclusions:

  • CT angiography identified radiological abnormalities in a small number of pediatric oropharyngeal trauma cases.
  • These findings do not support the routine use of CTA for screening due to radiation exposure.
  • CTA rarely led to changes in clinical management or improved outcomes in pediatric oropharyngeal trauma.
Abstract

Keywords:
CT angiographyoropharyngeal traumapediatrics

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