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

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.