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[Injuries of the nose in the newborn and young infant]
Insights
Nasal fractures are common in newborns and young children, presenting diagnostic and management challenges. Surgical intervention is indicated for recent fractures causing significant nasal obstruction and feeding issues.
Area of Science:
- Pediatric Otolaryngology
- Facial Trauma Surgery
- Neonatal Care
Context:
- Nasal fractures are frequent in newborns and young children.
- Accurate assessment and prediction of outcomes for these fractures are challenging.
- Complications like nasal obstruction and feeding difficulties require careful management.
Purpose:
- To review the characteristics and management of nasal fractures in newborns and young children.
- To highlight diagnostic difficulties and potential complications.
- To provide age-specific treatment guidelines, including surgical indications.
Summary:
- Fractures in newborns include prenatal and obstetrical types, with the latter often requiring surgery due to obstruction and feeding issues.
- Young children's fractures can be overlooked, with nasal hematomas posing a significant risk.
- School-aged children often sustain fractures associated with other facial injuries, necessitating prompt surgical evaluation for obstruction.
Impact:
- This review aids clinicians in diagnosing and managing pediatric nasal fractures effectively.
- It emphasizes timely surgical intervention for obstructive symptoms, improving patient outcomes.
- Understanding age-specific fracture patterns and complications can prevent long-term respiratory and aesthetic issues.
Abstract:
After having emphasized the frequency of the newborn's and young child's nasal fractures, the authors insist on the difficulty of: - a precise outcome of the lesions, - the complications due to nasal obstruction, - the impossibility to anticipate the evolution of these lesions, which is being precised by a brief embryological recall. The traumas are deliberately presented according to the age of the patients: 1) the newborn's fractures: - the prenatal fractures, which generally have a favorable evolution. - obstetrical traumas, with nasal obstruction and feeding difficulty, both being indications to surgery. 2) The young child's fractures: often misknown, and relatively frequent, the nasal wall's hematoma is a dreadful complication. 3) During school years: (sports, car accidents, Silverman's syndrome) Nasal fractures are here generally associated to other facial lesions. Indications to surgery: Always: If it is a recent fracture, provoquing nasal obstruction with respiratory and feeding problems. Sometimes: Septoplasty as minima in case of respiratory difficulties. Never perform true rhinoplasty and/or osteotomies.