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Ear, Nose and Throat Presentations

The following is a summary of the systematic review findings up to the date of our most recent literature search. If you have a specific clinical case, we strongly recommend you read all of the relevant references as cited and look for additional material published outside our search dates.


Children who present with epistaxis in the absence of direct trauma to the nose raises the possibility of asphyxiation 1. This finding has proved controversial, although a landmark study involving covert video surveillance identified that epistaxis was feasible following asphyxiation, however the precise association between the two has not been defined 2. Due to the significance of the findings, we aim to determine the probability of suffocation for a young child presenting with epistaxis.


While injuries to the ear, nose and throat as a consequence of physical abuse or resulting from fabricated or induced illness are not a frequently described manifestation, they are nonetheless important to identify. As the head and neck are the most frequently targeted organ in physical abuse, it would seem likely that ear, nose and throat injuries will result from this 3



The review seeks to answer the following review questions:


  1. What are the identified characteristics of epistaxis indicative of asphyxiation in children less than 2 years of age?
  2. What are the ear, nose and throat manifestations of physical abuse or fabricated or induced illness?



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  1. Hey E. Sudden oronasal bleeding in a young child. Acta Paediatrica. 2008;97(10):1327-1330 [Pubmed]

  2. Meadow R. Unnatural sudden infant death. Archives of Disease in Childhood. 1999;80(1):7-14 [Pubmed]

  3. Da Fonseca MAF. Dental aspects of 1248 cases of child maltreatment on file at a major county hospital. Pediatric Dentistry. 1992;14(3):152-157. [Pubmed]


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