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小儿鼻外伤:流行病学特征对鉴别鼻骨骨折与鼻软组织损伤的作用

Pediatric Nasal Traumas: Contribution of Epidemiological Features to Detect the Distinction Between Nasal Fractures and Nasal Soft Tissue Injuries.

作者信息

Cakabay Taliye, Ustun Bezgin Selin

机构信息

Kanuni Sultan Suleyman Training and Research Hospital, Otolaryngology Clinic, Istanbul, Turkey.

出版信息

J Craniofac Surg. 2018 Jul;29(5):1334-1337. doi: 10.1097/SCS.0000000000004550.

Abstract

OBJECTIVES

Nasal bone is prone to injury due of its prominent position on the face. Epidemiologic surveys are necessary to investigate nasal traumas. The aim of the present study is to examine the distribution of trauma etiologies according to age, sex, and seasonality in pediatric patients who present with nasal trauma, and to classify the pathologies according to their etiology as nasal fractures or nasal soft tissue injuries.

METHODS

A total of 200 pediatric patients aged between 0 and 18 years who were admitted to the emergency room with sustained nasal trauma between September 1, 2015 and August 1, 2016 and who were diagnosed with an either nasal fracture or nasal soft tissue injury were retrospectively analyzed. The relationship between the nasal bone fractures and nasal soft tissue injuries and age, sex, admission date, and trauma etiology were investigated.

RESULTS

Of 200 patients, 70.5% were males and 29.5% were females with a mean age of 8.93 ± 5.50 years. Of these patients, 33.0% were in the 0 to 5 years age group, 24.0% were in the 6 to 10 years age group, 18.5% were in the 11 to 14 years age group, and 24.5% were in the 15 to 18 years age group. Of these, 82.5% had a nasal soft tissue injury and 17.5% had a nasal fracture. The etiology of trauma was most commonly fall from a height in 42.5% of the patients. Impact injuries and falls were the most common etiologies in the 0 to 5 age group, falls were the most common etiologies in the 6 to 10 age group, sports injuries were the most common etiologies in the 11 to 14 age group, and physical assault was the most common etiology in the 15 to 18 age group (P = 0.001; P < 0.01). According to the paired comparisons, the rate of nasal fracture in the 0 to 5 age group was significantly higher than the rates in the 11 to 14 (P = 0.001) and 15 to 18 (P = 0.001) age groups (P < 0.05). The rate of nasal soft tissue injuries was significantly higher in the patients presenting to the emergency room with sustained impact injury to the nose or falls. The majority of the patients presenting with physical assault and sports injuries were males. Nasal soft tissue injuries were mostly seen in girls, whereas the rate of nasal fractures was higher in boys, which was directly proportional to the trauma etiology and severity of injury. The patients often presented in the summer season.

CONCLUSION

Our study results suggest that age, sex, time of trauma, and type of trauma guide the diagnosis of specific pathologies in pediatric patients presenting with sustained trauma. These characteristics must be specifically questioned and taken into consideration in the follow-up and treatment.

摘要

目的

鼻骨因其在面部的突出位置而易受损伤。进行流行病学调查对于研究鼻外伤很有必要。本研究的目的是调查鼻外伤儿科患者中创伤病因按年龄、性别和季节性的分布情况,并根据病因将病变分类为鼻骨骨折或鼻软组织损伤。

方法

回顾性分析2015年9月1日至2016年8月1日期间因鼻外伤持续而入住急诊室且被诊断为鼻骨骨折或鼻软组织损伤的200例0至18岁儿科患者。研究鼻骨骨折和鼻软组织损伤与年龄、性别、入院日期和创伤病因之间的关系。

结果

200例患者中,70.5%为男性,29.5%为女性,平均年龄为8.93±5.50岁。这些患者中,33.0%在0至5岁年龄组,24.0%在6至10岁年龄组,18.5%在11至14岁年龄组,24.5%在15至18岁年龄组。其中,82.5%有鼻软组织损伤,17.5%有鼻骨骨折。创伤病因最常见的是42.5%的患者从高处跌落。撞击伤和跌落是0至5岁年龄组最常见的病因,跌落是6至10岁年龄组最常见的病因,运动损伤是11至14岁年龄组最常见的病因,身体攻击是15至18岁年龄组最常见的病因(P = 0.001;P < 0.01)。根据配对比较,0至5岁年龄组的鼻骨骨折发生率显著高于11至14岁(P = 0.001)和15至18岁(P = 0.001)年龄组(P < 0.05)。因鼻部持续撞击伤或跌落而到急诊室就诊的患者中,鼻软组织损伤的发生率显著更高。遭受身体攻击和运动损伤的患者大多数为男性。鼻软组织损伤多见于女孩,而男孩的鼻骨骨折发生率更高,这与创伤病因和损伤严重程度成正比。患者常于夏季就诊。

结论

我们的研究结果表明,年龄、性别、创伤时间和创伤类型指导着有持续创伤的儿科患者特定病变的诊断。在随访和治疗中必须特别询问并考虑这些特征。

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