THÔNG TIN TÀI LIỆU
consistent with exposure to such pressure changes The treatment for sinus barotrauma is supportive, with pain control and antimicrobials TRAUMA TO THE ORAL CAVITY AND PHARYNX Goals of Treatment The emergent goal in oral and pharyngeal injuries is to evaluate and protect the airway when at risk for compromise or obstruction In addition, the emergency clinician must identify serious injuries that may involve vascular structures or wounds that may lead to infection Oral and pharyngeal foreign bodies should be removed promptly due to risk of aspiration Ingestion and aspiration is covered in detail in Chapter 32 Foreign Body: Ingestion and Aspiration , Chapter 91 Gastrointestinal Emergencies , and Chapter 124 Thoracic Emergencies CLINICAL PEARLS AND PITFALLS Falls with objects in the mouth may result in injuries to the vascular structures, potentially resulting in CNS complications Foreign bodies may be retained in the oral cavity Current Evidence A common etiology of oral cavity injury is biting of the cheek causing a laceration or hematoma Palatal injuries are usually caused by a foreign body, often as a result of falling with something in or around the patient’s mouth Risk of associated injury can be stratified based on location of the trauma within the oral cavity Central hard or soft palate injuries are not likely to be associated with neurovascular injury Lateral palate, especially soft palate or tonsillar fossa is associated with vascular injury given the close proximity to the carotid sheath Posterior pharyngeal wall injuries may be associated with vascular injuries resulting in hematoma and risk of infection Clinical Considerations Clinical Recognition Oral or pharyngeal injuries in children often result from a fall, foreign body, ingestion, or blow from a projectile object such as a ball Triage
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