Post-traumatic nasal deformations in children

Eliza Brożek-Mądry, Mieczysław Chmielik, Anna Bielicka, Lechosław P. Chmielik, Małgorzata Dębska, Lidia Zawadzka-Głos

Summary
Objective: Epidemiology and physiopathology analysis of post-traumatic nasal deformations in children.
Methods: The study materials included documentation of patients of the Paediatric Otolaryngology Department of the Medical University in Warsaw as well as information researched in literature, concerning recent or past post-traumatic nasal deformations in children. The consequences of trauma were classified according to the type of lesions they were followed by i.e.: a) soft tissues damage b) fractures with or without dislocation, c) septum haematoma or abscess formation. Nasal deformations included nasal dorsum deformations, septum cartilaginous or osseous deformations and nasal septum cartilage loss.
Results: In 2003-2005, 944 were followed up after past nasal trauma at the Outpatient Clinic. Among them, 77 children were admitted due to complications of recent nasal trauma. These children underwent closed reduction and/or closed septum reduction and/or incision and drainage of the septum haematoma or abscess. Five children were diagnosed with septum haematoma/abscess. Seventy eight children were admitted to the Department because of septum deviation. They were analysed for past nasal trauma and type of deformation. These patients underwent either septoplasty or septoplasty with osteotomy. The analysis also included 44 patients who underwent surgical reconstructions of the nasal septum performed with preserved cartilage or autogenous costal cartilage.
Conclusions: Every nasal trauma in a child should be properly and thoroughly evaluated and followed up in order to prevent late complications including osseous or cartilaginous skeleton deformations. Establishing and initiating appropriate management schemes together with professional otolaryngological medical training may decrease the incidence of these deformations.

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