Pediatric Nasal Injuries and Management

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.

Hockey-related facial injuries: A population-based analysis

“…Pediatric nasal fractures present a management dilemma because there is controversy over whether they should be immediately repaired. Repair while the midface is still developing has the potential to alter natural growth . Further prospective study regarding optimal management strategies and surgical intervention patterns among pediatric hockey players may be of value for facial plastic surgeons and otolaryngologists.…”

Management of nasoethmoid fractures

“…Nasal growth occurs during early childhood from age 2 to 5 and again at puberty in spurts separated by periods of proportional growth at two growth centres along the nasal septum [18]. Controversy exists surrounding the timing of repairs, methods of reconstruction, use of nasal packing and use of plating materials.…”

Pediatric nasal bone fractures: Does delayed treatment really lead to adverse outcomes?

“…However, there are very few reports evaluating the long-term results of pediatric nasal bone fractures, and no reports on the link between time to surgery and surgical outcome in a pediatric population [17][18][19]. A pediatric nasal bone fracture is believed to require earlier reduction than in adults, typically within 3-7 days [6][7][8][9].…”