Intended for healthcare professionals


Penetrating intraoral trauma may occur in adults as well as children

BMJ 1997; 314 doi: (Published 05 April 1997) Cite this as: BMJ 1997;314:1043
  1. S S Rayatt, Senior house officer in plastic surgerya,
  2. P Hamlyn, Consultant in neurosurgerya,
  3. P Magennis, Specialist registrar in maxillofacial surgeryb
  1. a Royal London Hospital, London E1 2BB
  2. b Walton Hospital, Liverpool L9 1AE

    Editor—R C Law and colleagues present an excellent account of the hidden dangers of penetrating intraoral trauma in children.1 Although this type of injury is more commonly seen in children,2 it should not be overlooked in adults.

    We recently treated a 28 year old man who had been assaulted with an umbrella. An obvious lip injury was noted, but an oropharyngeal injury, in the same trajectory, was missed, and he presented 24 hours later with hemiplegia and aphasia. Contrast computed tomography and angiography confirmed thrombosis of the carotid artery secondary to trauma to the posterior pharyngeal wall (fig 1). Thrombosis can also occur secondary to blunt head and neck trauma.3

    Fig 1
    Fig 1

    Intravenous digital subtraction angiogram arch aortagram showing complete occlusion of left internal carotid artery (arrow)

    We would re-emphasise the need to make parents aware of the dangers of children walking around with sharp objects in their mouth. We would also recommend thorough oral examination in patients–adults as well as children–presenting with perioral as well as intraoral trauma.


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