Facial injuries and accidents, Do I need to see an ENT?

If it’s a Summer Saturday on the Eastern Shore, you’ll likely find families gathered at the ballpark or enjoying water sports on the bay.  The crack of the bat and the splash of kids jumping off a pier also bring some of our youngest patients in the door this time of year, with broken noses or other forms of facial trauma.

About three million people a year are treated in emergency departments for facial trauma. Of pediatric patients, 5% have suffered facial fractures.  For those under three, the cause is usually a fall. After the age of five, many of those injuries are caused by motor vehicle accidents where a seat belt, booster or car seat either wasn’t used or installed correctly.

Of all facial trauma injuries, a broken nose is the most common. The bone is the bridge of the nose and the cartilage includes the septum, or wall inside the nose that divides the nostrils.  Because the nose sticks out, it’s vulnerable to fracture. In most cases, a broken nose causes a bent or crooked nose and changes breathing. If a doctor doesn’t reposition the bones within two weeks, your child’s nose may heal crooked and need formal reconstructive surgery to correct it.

You can’t always tell if your child’s nose is broken right away. Swelling can obscure whether it’s bent or not.  That’s why it’s best to evaluate the nose 3 to 5 days after the injury when swelling has decreased. Still – a nose may be broken but not bent if the break was minor.

On a related note, a blow to the face often impacts the teeth as well – and a call to your family dentist should be a priority. If a permanent tooth is “knocked out” it should be immediately washed under cold water and placed back in the tooth socket.  Take care to only touch the crown (the white part) of the tooth. The sooner the tooth is re-inserted into the tooth socket the better the chance it will survive.  If this is not an option, place it in salt water, milk or even saliva. Avoid storage in plain water. See your dentist as soon as possible! Never attempt to clean up the tooth or “wipe it off”, as remnants of the ligament which hold the tooth in the jaw are attached and vital to chances of replanting the tooth successfully.

In addition to broken bones of the face there are other ENT conditions that can result from summertime accidents. Falls from water skis and wakeboards can cause your eardrum to perforate, sometimes leading to ear pain and drainage immediately after the event. Fortunately, more than 85% of these will heal on their own, but monitoring the progress is important to prevent problems down the road. There are also the normal scrapes and cuts that come with fun in the outdoors. Eastern Shore ENT is prepared to fix these problems with sutures or skin glue if needed.

The health risks of an inactive lifestyle far outweigh the risks of injury in sports! Do not hesitate to jump into gymnastics, swimming, football, baseball, soccer, or the water. Just remember that when an accident does occur and a specialist is needed, Eastern Shore ENT is here to help.

Brian Hixon, MD