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Oropharyngeal trauma in children

Author
David W Roberson, MD
Section Editor
Richard G Bachur, MD
Deputy Editor
James F Wiley, II, MD, MPH

INTRODUCTION

Children often fall with objects in their mouths and may suffer trauma to the oropharynx. These injuries pose a significant diagnostic challenge because the vast majority will heal spontaneously without complications [1-4], but a small minority will develop deep neck infections or carotid artery injuries that cause major morbidity and mortality [5-10]. The approach to oropharyngeal blunt trauma relies on an assessment of the oropharyngeal wound, a rational use of diagnostic tools, primarily noninvasive radiologic techniques, and surgical intervention in selected patients.

This review covers the evaluation and management of wounds to the hard and soft palate, tonsils, and posterior pharyngeal walls. Dental and tongue injuries are discussed separately. (See "Evaluation and management of dental injuries in children" and "Evaluation and repair of tongue lacerations".)

EPIDEMIOLOGY

Oropharyngeal injuries account for an estimated 1 percent of all pediatric trauma [11]. A common mechanism involves a toddler or preschool child falling with an object in the mouth or having an item pushed into their mouth by a playmate or caregiver. Commonly reported objects include writing instruments (eg, pen, pencil), toothbrushes, Popsicle sticks, lollipops, eating utensils, and drinking straws [2,12]. Infrequently, the trauma may result from a blind finger sweep by a caregiver during a choking episode [12].

ANATOMY AND PATHOPHYSIOLOGY

The oropharynx consists of the following structures:

Soft palate, uvula above

                                   

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Literature review current through: Nov 2016. | This topic last updated: Thu Aug 11 00:00:00 GMT 2016.
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