Hook, Line, and Sinker: Anatomical Distribution of Head and Neck Fishing Injuries in Children

Introduction Fishhooks are designed to grab tissue. The goal of this study was to determine which head and neck locations were most involved in pediatric fishing-related injuries. Methods The National Electronic Injury Surveillance System (NEISS) was queried for fishing-related head and neck injuries between 2013 and 2022 in patients <19 years old. Demographics, including age, gender, and race, were collected. Cause of injury, head and neck location, and disposition were analyzed. Rashes (N=57) and non-fishing injuries (N=30) were excluded. Results A total of 697 children, 546 (78.3%) male and 151 (21.7%) female, were included. Mean age was 9.5 (95% CI 9.1-9.8) years. Causes of injury included fishhooks (N=590, 84.6%), falls (N=52, 7.5%), fishing poles or nets (N=31, 4.4%), sinkers (N=13, 1.9%), fish (N=2, 0.3%), and other causes (N=9, 1.25%). The national estimate for pediatric head and neck fishing-related injuries was 37,467 for this 10-year period. There was a significant difference in the anatomical distribution of hook vs. non-hook injuries (p<0.001). Fishhook injuries mostly occurred in the face (N=237/590, 40.2% of fishhook injuries); non-hook injuries were most common on the head (N=48/107, 44.9% of non-hook injuries). Fishhook injuries were more common than non-hook-related injuries in the ear (N=80/590, 13.6% vs. N=1/107, 0.9%) and the eyelids (N=47/590, 8.0% vs. N=4/107, 3.7%). Children with pole-related injuries (N=31) were significantly younger (mean 6.5 vs. 9.6 years; p<0.001); these were most common in the face (N=15/31, 48.4%) and mouth (N=10/31, 32.3%). Conclusion Pediatric fishhook impalements in the face and ear are common, requiring otolaryngologists to be adept in their management.