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Pediatric Facial Trauma: A Review of Guidelines for Assessment, Evaluation, and Management in the Emergency Department

Ryan, Mark Leo MD; Thorson, Chad M. MD; Otero, Christian A. MD; Ogilvie, Michael P. MD, MBA; Cheung, Michael C. MD; Saigal, Gaurav M. MD; Thaller, Seth R. MD, DMD

Journal of Craniofacial Surgery: July 2011 - Volume 22 - Issue 4 - p 1183-1189
doi: 10.1097/SCS.0b013e31821c0d52
Original Articles

Approximately 22 million children in the United States sustain traumatic injuries every year, the etiologies of which vary with age as well as social and environmental factors. If not managed properly, these injuries can have a significant impact on future growth and development. Evaluation of facial injuries presents a unique diagnostic challenge in this population, as differences from adult anatomy and physiology can result in vastly different injury profiles. The increased ratio of the cranial mass relative to the body leaves younger patients more vulnerable to craniofacial trauma. It is essential that the treating physician be aware of these variations to properly assess and treat this susceptible and fragile patient population and ensure optimal outcomes. This article reviews the proper emergency department assessment and treatment of facial fractures in the pediatric population as well as any associated injuries, with particular emphasis on initial patient stabilization, radiological evaluation, and therapeutic options.

From the Dewitt-Daughtry Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida.

Received October 12, 2010.

Accepted for publication November 4, 2010.

Address correspondence and reprint requests to Mark Leo Ryan, MD, University of Miami/Jackson Memorial Hospital, JMH/Ryder Trauma Center, 1850 NW 9th Ave, T242, Miami, FL 33136; E-mail:

The authors report no conflicts of interest.

© 2011 Mutaz B. Habal, MD