Abstract
To examine the clinical factors that influence medical decision making in children with oropharyngeal trauma. Retrospective chart review (spanning 6 years). Tertiary care children's hospital. One hundred seven consecutive children with traumatic oropharyngeal injuries. Computed tomographic angiography (CTA) (n = 52), surgical therapy (n = 16), inpatient admission (n = 44), and antibiotic administration (n = 77). The likelihood of a patient undergoing each of the 4 interventions and having positive radiographic findings or clinical complications was assessed with respect to the following clinical factors: (1) age, (2) sex, (3) mechanism of injury, (4) site of injury, (5) wound severity (3-point scale), and (6) otolaryngology consultation. The following factors were significantly associated with an increased likelihood of a patient undergoing CTA to rule out occult internal carotid artery damage: (1) injury to the lateral soft palate, (2) high wound severity score, and (3) otolaryngology consultation. Radiographic abnormalities (including free air, parapharyngeal edema, and hematoma) were present in 16 (31%) of 52 CTAs but were not associated with any specific clinical factors. Patients with more severe wounds were more likely to...Continue Reading
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