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European Archives of Oto-Rhino-Laryngology

, Volume 276, Issue 1, pp 85–91 | Cite as

Blunt nasal trauma in children: a frequent diagnostic challenge

  • Urs Borner
  • Lukas AnschuetzEmail author
  • Nadine Kaiser
  • Alexander Rieke
  • Patrick Dubach
  • Marco Caversaccio
Rhinology

Abstract

Objective

The clinical challenge in blunt nasal trauma in children, is to identify cases requiring specialized care among frequently encountered banalities, whilst trying to minimize the exposure to diagnostic procedures. We aim to evaluate the related diagnostic and therapeutic pathways and its outcome during follow-up.

Methods

This retrospective cohort study includes children up to 16 years presenting at the emergency department with blunt nasal trauma of our tertiary reference center.

Results

The incidence of blunt nasal injuries was estimated 1750 cases in 7 years. A total of 459 consecutive cases with suspected complications were enrolled. Univariate comparison between age groups revealed a statistically significant diminution of downfall related injuries with growing up, whereas blows (including violence) significantly increased with age (p < 0.001 each). The logistic regression model identified male sex as an independent risk factor for soft tissue lesions (OR 1.699, p = 0.017) and for frontobasal fractures (OR 2.415, p = 0.050). Age was not identified to play a significant role regarding localization of injuries. Delayed septorhinoplasties became necessary in 2 cases only (0.4%). The logistic regression model identified nasal bone fracture (OR 17.038, p < 0.001) and mandibular fracture (OR 4.753, p = 0.004) as independent risk factor for a surgical intervention.

Conclusions

Blunt trauma to the nose is frequent in children. Trauma mechanisms differ significantly between age groups, whereas localization and concomitant injuries do not. Male sex was identified as an independent risk factor for soft tissue lesions and frontobasal fractures. In our experience, initial triage by the pediatric department with consecutive involvement of the ENT specialists in case of suspected complications is safe and effective and may help to reduce unnecessary diagnostic procedures/irradiation to the young patients.

Keywords

Pediatric nose trauma Complications Outcome Treatment Nasal fracture Closed reposition 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare no conflict of interest.

Research involving human and/or animal participants

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional, regional and national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed consent

For this type of study, formal consent is not required.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Otorhinolaryngology, Head and Neck SurgeryInselspital, University Hospital and University of BernBernSwitzerland
  2. 2.Department of Pediatric Surgery, Inselspital, Bern University HospitalUniversity of BernBernSwitzerland
  3. 3.Department of RadiologyKantonsspital GraubuendenChurSwitzerland
  4. 4.Department of Otorhinolaryngology, Head and Neck SurgeryBurgerspital SolothurnSolothurnSwitzerland

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