PMID: 8949311Sep 1, 1996Paper

Occult pharyngeal perforation secondary to 'pencil injury'

The Journal of Laryngology and Otology
D A SmythD P McShane

Abstract

Palatopharyngeal injuries due to impaction of rigid objects held in the mouth are common. Most are essentially innocuous injuries requiring no specific treatment. However, there is the potential for perforation of the pharyngeal wall with the subsequent development of serious infection such as retropharyngeal abscess or mediastinitis. This possibility is more likely to be suspected in the presence of a visible laceration or puncture wound at the site of impact in the mouth or pharynx. We report three cases in which occult pharyngeal perforation occurred without any clinical signs of breech of the pharyngeal wall. In all cases a lateral soft tissue neck X-ray was diagnostic of perforation, showing the presence of retropharyngeal air. We, therefore, advocate the routine performance of soft tissue neck X-rays in all patients who present with a history of falling on a rigid object held in the mouth.

References

Sep 1, 1992·The Journal of Laryngology and Otology·H KosakiY Toriyama
Mar 1, 1992·The Annals of Otology, Rhinology, and Laryngology·S R DolginA J Maniglia
Oct 1, 1990·The Annals of Thoracic Surgery·J A NiezgodaG M Graeber
Aug 1, 1989·The Journal of Laryngology and Otology·B Mains, M Nagle
Mar 1, 1993·International Journal of Pediatric Otorhinolaryngology·J R HellmannM J Gootee
Jul 11, 1964·British Medical Journal·E R BICKERSTAFF

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Citations

May 14, 2005·Pediatric Surgery International·Zubair LuqmanZafar Nazir
Dec 17, 2005·Journal of Clinical Forensic Medicine·Houshang Moin, Hossein A Khalili
Jul 9, 2002·The Journal of Infection·K-I KobayashiT Nishio
Nov 11, 2003·The Journal of Trauma·Antonio E Martin-UcarRoger Vaughan
Dec 22, 2006·International Journal of Paediatric Dentistry·O James Younessi, Eduardo A Alcaino

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