Abstract:
Intraoral injuries are frequently encountered in emergency departments due to children\'s desire and curiosity to put objects in their mouths. However, forward falls with objects in children\'s mouths can cause impalement injuries to soft palate, retropharyngeal-peritonsillar, and retromolar tissues, leading to serious morbidity and even mortality. These transoral (soft palate, pharynx-tonsil, retromolar region) penetration injuries can especially result in damage to major vascular structures like the Internal Carotid Artery (ICA) due to their close proximity. Dissection, thrombosis, and subsequent stroke can occur in the delicate ICA as a result. In the presented case, a 3-year-old male child experienced internal carotid artery dissection following penetrating injury with a pen, as demonstrated by imaging studies. A literature review is provided along with the case of this child, who developed a reduction in middle cerebral artery (MCA) flow due to thrombosis in the ICA. The study encompasses all penetrating oropharyngeal traumas reported in individuals aged 0-18 years from 1936 to 2023. A search in PubMed and Google Scholar using keywords such as \'internal carotid artery injury,\' \'penetrating trauma,\' and \'children\' yielded 78 case reports from a pool of 36,000 studies. The analysis excludes injuries in areas like tongue, cheek, gums, lips, and floor of the mouth, post-tonsillectomy injuries, and those from sudden braking vehicles. This review encompasses the evaluation, diagnosis, and treatment of penetrating injuries to the soft palate, pharyngeal wall, tonsil, and retromolar regions.
摘要:
由于儿童渴望和好奇将物体放入嘴里,急诊部门经常遇到口腔内损伤。然而,儿童嘴里有物体的向前跌倒会导致软腭受到刺穿伤害,咽后-扁桃体周围,和磨牙后组织,导致严重的发病率甚至死亡率。这些经口(软腭,咽扁桃体,磨牙后区域)穿透损伤尤其会导致颈动脉(ICA)等主要血管结构的损伤。解剖,血栓形成,因此,随后的中风可能会发生在微妙的ICA中。在本案中,一名3岁的男性儿童在用笔穿透性损伤后经历了颈内动脉夹层,正如影像学研究所证明的那样。连同这个孩子的案例一起提供了文献综述,由于ICA中的血栓形成,导致大脑中动脉(MCA)流量减少。该研究涵盖了从1936年到2023年在0-18岁的个体中报告的所有穿透性口咽创伤。在PubMed和GoogleScholar中使用“颈内动脉损伤”等关键字进行搜索,\'\'穿透性创伤,\'和\'儿童\'从36,000项研究中产生了78例病例报告。分析排除了舌头等部位的损伤,脸颊,牙龈,嘴唇,和嘴巴的地板,扁桃体切除术后损伤,以及那些来自突然刹车的车辆。这项审查包括评估,诊断,以及软腭穿透性损伤的治疗,咽壁,扁桃体,和后磨牙区。