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Facial Plast Surg 2011; 27(5): 483-490
DOI: 10.1055/s-0031-1288931
© Thieme Medical Publishers

Pediatric Nasal Injuries and Management

Richard J. Wright1 , Craig S. Murakami2 , Bryan T. Ambro1
  • 1Department of Otorhinolaryngology–Head and Neck Surgery, University of Maryland Medical Center, Baltimore, Maryland
  • 2University of Washington, Virginia Mason Medical Center, Seattle, Washington
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Publication History

Publication Date:
25 October 2011 (online)

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ABSTRACT

Although serious trauma injuries are uncommon in the pediatric population, nasal injuries are a more common problem. In this population, many physicians are uncomfortable managing these injuries. The evaluation and treatment of nasal trauma differ considerably in children compared with adult nasal fractures. Poor patient cooperation during the physical exam coupled with significant anatomic differences can present the nasal surgeon with a difficult diagnostic dilemma. The surgical management of pediatric nasoseptal injuries is not without controversy, as disturbing the nasal growth centers can have significant effect on future nasal and midfacial development. This article reviews the diagnostic and therapeutic challenges presented by these injuries for children and provides recommendations to successfully manage nasal injuries in this population.

KEYWORDS

Pediatric nasal trauma - children - septorhinoplasty

REFERENCES

  • 1 Goode R L, Spooner T R. Management of nasal fractures in children. A review of current practices.  Clin Pediatr (Phila). 1972;  11 526-529
    Google Scholar
  • 2 Meier J D, Tollefson T T. Pediatric facial trauma.  Curr Opin Otolaryngol Head Neck Surg. 2008;  16 555-561
    Google Scholar
  • 3 Vyas R M, Dickinson B P, Wasson K L, Roostaeian J, Bradley J P. Pediatric facial fractures: current national incidence, distribution, and health care resource use.  J Craniofac Surg. 2008;  19 339-349 discussion 350
    Google Scholar
  • 4 Kaban L B, Troulis M J eds.. Pediatric Oral and Maxillofacial Surgery. 2nd ed. Philadelphia: Saunders; 2004
    Google Scholar
  • 5 Alcalá-Galiano A, Arribas-García I J, Martín-Pérez M A, Romance A, Montalvo-Moreno J J, Juncos J M. Pediatric facial fractures: children are not just small adults.  Radiographics. 2008;  28 441-461 quiz 618
    Google Scholar
  • 6 Perkins S W, Dayan S H, Sklarew E C, Hamilton M, Bussell G S. The incidence of sports-related facial trauma in children.  Ear Nose Throat J. 2000;  79 632-634 636 638
    Google Scholar
  • 7 Gassner R, Tuli T, Hächl O, Moreira R, Ulmer H. Craniomaxillofacial trauma in children: a review of 3,385 cases with 6,060 injuries in 10 years.  J Oral Maxillofac Surg. 2004;  62 399-407
    Google Scholar
  • 8 Alcaraz N, Lawson W. Trauma of the nose and nasoethmoid complex in children and adolescents.  Facial Plast Surg Clin North Am. 1999;  7 175-183
    Google Scholar
  • 9 Shandilya M, Den Herder C, Dennis SCR, Nolst Trenité G. Pediatric rhinoplasty in an academic setting.  Facial Plast Surg. 2007;  23 245-257
    Google Scholar
  • 10 Verwoerd CDA, Verwoerd-Verhoef H L. Rhinosurgery in children: basic concepts.  Facial Plast Surg. 2007;  23 219-230
    Google Scholar
  • 11 Latham R A. Maxillary development and growth: the septo-premaxillary ligament.  J Anat. 1970;  107 (Pt 3) 471-478
    Google Scholar
  • 12 Precious D S, Delaire J, Hoffman C D. The effects of nasomaxillary injury on future facial growth.  Oral Surg Oral Med Oral Pathol. 1988;  66 525-530
    Google Scholar
  • 13 Grymer L F, Gutierrez C, Stoksted P. Nasal fractures in children: influence on the development of the nose.  J Laryngol Otol. 1985;  99 735-739
    Google Scholar
  • 14 Sambajon V V, Johns F R, Ochs M W. Management of avulsive injuries of the nasal bones: review of the literature and three case reports.  J Craniomaxillofac Trauma. 1998;  4 24-31
    Google Scholar
  • 15 Stranc M F, Robertson G A. A classification of injuries of the nasal skeleton.  Ann Plast Surg. 1979;  2 468-474
    Google Scholar
  • 16 Flint P, Haughey B, Lund V et al, eds.. Cummings: Otolaryngology–Head and Neck Surgery. 5th ed. Philadelphia: Mosby Elsevier; 2010
    Google Scholar
  • 17 Moran W B. Nasal trauma in children.  Otolaryngol Clin North Am. 1977;  10 95-101
    Google Scholar
  • 18 Jazbi B. Subluxation of the nasal septum in the newborn: etiology, diagnosis, and treatment.  Otolaryngol Clin North Am. 1977;  10 125-138
    Google Scholar
  • 19 Stoksted P, Schønsted-Madsen U. Traumatology of the newborn's nose.  Rhinology. 1979;  17 77-82
    Google Scholar
  • 20 Sorri M, Laitakari K, Vainio-Mattila J, Hartikainen-Sorri A L. Immediate correction of congenital nasal deformities; follow-up of 8 years.  Int J Pediatr Otorhinolaryngol. 1990;  19 277-283
    Google Scholar
  • 21 Becker O J. Nasal fractures; an analysis of 100 cases.  Arch Otolaryngol. 1948;  48 344-361
    Google Scholar
  • 22 Olsen K D, Carpenter III R J, Kern E B. Nasal septal injury in children. Diagnosis and management.  Arch Otolaryngol. 1980;  106 317-320
    Google Scholar
  • 23 Dennis SCR, den Herder C, Shandilya M, Nolst Trenité G J. Open rhinoplasty in children.  Facial Plast Surg. 2007;  23 259-266
    Google Scholar
  • 24 Stucker Jr F J, Bryarly R C, Shockley W W. Management of nasal trauma in children.  Arch Otolaryngol. 1984;  110 190-192
    Google Scholar

Bryan T AmbroM.D. M.S. 

Assistant Professor, Director, Division of Facial Plastic and Reconstructive Surgery, Department of Otorhinolaryngology–Head and Neck Surgery, University of Maryland Medical Center

16 South Eutaw Street, Suite 500, Baltimore, MD 21201

Email: bryanambro@yahoo.com

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