Evaluation of pediatric lateral oropharyngeal trauma

OBJECTIVE: We reviewed the mechanism of injury, presentation, and evaluation of children with trauma to the lateral oropharynx. STUDY DESIGN AND SETTING: We conducted a retrospective review of patients in an urban pediatric emergency department with trauma to the lateral oropharynx over a 5-year period. RESULTS. Forty-eight patients were identified with documented injuries of the lateral oropharynx placing the internal carotid artery at risk of injury. The average age was 42 months, with a male-to-female ratio of 1.5:1. Seventy-seven percent of patients had a documented neurologic examination. Examinations were normal in all cases. Computed tomography scans were obtained in 14 patients, identifying 3 patients with carotid abnormalities. Angiography subsequently diagnosed intimal injuries in 2 of the 3 patients. There were no known cases of neurovascular compromise. CONCLUSION: Contrast-enhanced computed tomography may be an effective screening examination in this patient population, helping to determine which children should be admitted for angiography and observation.