Traumatic Injuries to the Head and Neck
The bones in the nose are the most frequently broken (fractured) in the face. Identification of a nasal bone fracture in children is not easy, as there is usually a lot of swelling, making touching the nose difficult. Additionally, x-rays are difficult to interpret. Immediate evaluation is necessary to make sure a collection of blood (haematoma) is not present in the septum (divider of the nose). If no haematoma is found, the patient is usually re-examined in two to three days, once the swelling has gone down. If the nose looks crooked, then immediate evaluation by an ear, nose and throat surgeon is necessary.
If a fracture is found, correction is usually performed by moving the nose into its normal position (reduction), as soon as possible. This is best performed within 7 to 10 days after the fracture. In more complicated fractures, or when fracture reduction has been delayed, a SEPTORHINOPLASTY may need to be performed at a later date.
IN THE MOUTH (INTRAORAL) INJURIES
Injuries involving the palate (roof of the mouth) are common in children. These usually occur when a child is running or playing with something in the mouth like a pencil, toothbrush or stick. Other injuries that may occur in the mouth include cuts or tears on the tongue, tonsils, and/or inside the cheek.
Cuts on the tongue if small usually heal on their own. Larger cuts may require stitches. However, it is common for stitches in the tongue to pull out because the tongue is a large muscle.
Tears on the soft palate usually heal on their own. However, if the cut extends to the side of the roof of the mouth, the patient may be admitted to the hospital for observation to make sure a large blood vessel (carotid artery) has not been injured. A special test called an angiogram may also be necessary.
Hard Palate lacerations are also allowed to heal. However, if there is extensive swelling or a chance of AIRWAY OBSTRUCTION, hospital observation and a possible
Lacerations (cuts) can occur inside the ear in the outer ear canal (external auditory canal). A short-term complication with these lacerations includes infection; therefore, packing of the ear with antibiotic medicine is usually advised. A longer-term complication can include narrowing of the outer ear canal once the laceration heals, which, if problematic may require correction. The eardrum (tympanic membrane) can also tear causing a perforation. This will cause hearing loss at least temporarily. Drops should not be used in this situation because it may delay healing of the perforation. If the tear doesn't heal on its own, TYMPANOPLASTY may be required. Your ear, nose and throat specialist will perform hearing tests after healing to ensure the hearing has returned to normal.
NECK (LAYRNGEAL) TRAUMA
Trauma to the larynx (voice box) can occur by an injury to the front of the neck, as well as a significant hit to the back of the neck (upper spine). The biggest immediate concern with this type of injury is to evaluate for signs of AIRWAY OBSTRUCTION.