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Nasal septal injury in children. Diagnosis and management
Insights
Nasal septal trauma in children is often overlooked, leading to serious functional and cosmetic issues. Prompt intranasal examination and treatment are crucial to prevent long-term complications from these injuries.
Area of Science:
- Otolaryngology
- Pediatric Traumatology
- Plastic Surgery
Background:
- Nasal septal trauma is a common childhood injury, frequently undiagnosed.
- Delayed diagnosis can lead to significant functional and cosmetic sequelae.
- Intranasal examination is critical for identifying all injuries.
Observation:
- Minor nasal injuries can result in severe destructive outcomes.
- Untreated septal injuries can cause nasal respiratory and external abnormalities.
- Case report illustrates the destructive sequelae of seemingly minor nasal trauma.
Findings:
- Complete intranasal examination detects fractures, dislocations, lacerations, hematomas, and abscesses.
- Surgical intervention may be necessary for hematoma evacuation and septal reconstruction.
- Management of cartilage resorption secondary to hematoma/abscess is reviewed.
Implications:
- Early diagnosis and treatment of nasal septal trauma are essential.
- Surgical techniques for septal reconstruction can restore form and function.
- Understanding potential complications guides effective pediatric nasal trauma management.
Abstract:
Although nasal injury is common-place in childhood, nasal septal trauma often is neglected and frequently goes undiagnosed until complications ensue. Only a complete intranasal examination in all cases of nasal trauma will detect intranasal fractures, dislocations, lacerations, hematomas, and abscess formation. Untreated, these septal and associated injuries can lead to considerable functional (nasal respiratory) and cosmetic (external) abnormalities. We report a case to illustrate the destructive sequelae of a "minor" nasal injury. Treatment may require formal surgical exploration with hematoma evacuation, reconstruction of the septal skeletal structures, and repair of lacerations of the intranasal mucosa. We review the management of cartilage resorption secondary to hematoma or abscess formation. A technique for replacing the caudal end of the septum is discussed and illustrated.