Smyth D A, Fenton J, Timon C, McShane D P
Department of Otolaryngology/Head and Neck Surgery, National Children's Hospital, Dublin, Ireland.
J Laryngol Otol. 1996 Sep;110(9):901-3.
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.
因口中持有的坚硬物体撞击导致的腭咽损伤很常见。大多数损伤本质上无害，无需特殊治疗。然而，存在咽壁穿孔的可能性，随后可能发展为严重感染，如咽后脓肿或纵隔炎。在口腔或咽部撞击部位出现可见的撕裂伤或穿刺伤口时，更有可能怀疑这种可能性。我们报告了3例隐匿性咽穿孔病例，这些病例没有任何咽壁破裂的临床体征。在所有病例中，颈部软组织侧位X线片诊断出穿孔，显示有咽后积气。因此，我们主张对所有有口中持有的坚硬物体撞击史的患者常规进行颈部软组织X线检查。
