Assault Related Otorhinolaryngology Head And Neck Injuries In Children And Adolescents: A Prospective Study From A Tertiary Health Institution In Southwestern Nigeria
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Keywords
Adolescent ENT trauma, sociodemographic disparities, epidemiology, management outcome, assault related head and neck injuries
Abstract
Background: Children and adolescents’ assault-related otorhinolaryngology injuries pose critical public health challenges in resource-limited settings, yet comprehensive data from developing countries remain scarce. This study determined the otorhinolaryngology head and neck presentation, epidemiology, pathology, and management of children and adolescents with assault over a 5-year period of otorhinolaryngology, head and neck surgical practices in Nigeria.
Methodology: A prospective study of 368 patients aged <1–18 years treated for assault-related otorhinolaryngology injuries (2019–2023) at a tertiary hospital in Nigeria. Data included sociodemographics, injury profiles, management, and outcomes. Statistical analyses employed descriptive frequencies, chi-square, Mann-Whitney U, and multivariable regression (SPSS version 29.0; α=0.05).
Results: Adolescents (13–18 years) comprised 44.02% of cases, with male predominance (54.62%). Physical abuse (67.39%) by family members (45.65%) was predominant, peaking in summer (30.43%). Nasal injuries (40.22%) and blunt trauma (61.41%) were most frequent; 12.50% had life-threatening severity (ISS ≥16). Infections (20.65%) were the leading complication. Rural dwellers presented 18 hours later than urban counterparts (median 36h vs. 18h; p<0.001). Surgical management reduced complications by 20.68% vs. conservative treatment (32.65% vs. 53.33%; OR=0.42, p=0.004). Low SES independently predicted severe injury (OR=2.44, 95% CI:1.33–4.47) and disability (OR=1.82, 95% CI:1.12–2.97). 2.17% (n=8), linked to delayed presentation (>72h: OR=2.51, p=0.001) and severe ISS.
Conclusion: Assault-related children and adolescent otorhinolaryngology injuries in developing countries reflect intersecting vulnerabilities: poverty, healthcare access barriers, and family-centered violence. Decentralizing trauma care, criminalizing corporal punishment, and prioritizing surgical triage for high-risk injuries (neck/throat: OR=4.26) are urgently needed to reduce mortality and disability.
References
2. Adegbiji WA, Olatunya OS, Olajuyin OA, Babatola AO, Komolafe AK. Paediatric otorhinolaryngology, head and neck emergencies at a Tertiary Health Care Centre in Nigeria. Nigerian Journal of Medicine. 2020;29(1):137-141.
3. Biswas A, Harbin S, Irvin E, Johnston H, Begum M, et al. Sex and gender differences in occupational hazard exposures: a scoping review of the recent literature. Current environmental health reports. 2021;8(4):267-280.
4. Mahboob A, Richmond SA, Harkins JP, Macpherson AK. Childhood unintentional injury: The impact of family income, education level, occupation status, and other measures of socioeconomic status. A systematic review. Paediatrics & child health. 2021;26(1):e39-e45.
5. Banerjee N, Sharma N, Soni KD, Bansal V, Mahajan A, et al. Are home environment injuries more fatal in children and the elderly? Injury. 2022;53(6):1987-1993.
6. Alordiah CO, Omumu FC, Owamah HI, Chenube O, Okokoyo IE, et al. Socio-cultural norms encouraging violence against women (VAW) from a popular ethnic group in the Niger Delta region of Nigeria and the roles of schools in preventing VAW. Cogent Social Sciences. 2022;8(1):2102299.
7. Meng D, Chen J. Hearing Damage Through Blast. Explosive Blast Injuries: Principles and Practices. 2023;301-317.
8. Shilston J, Evans DL, Simons A, Evans DA. Initial management of blunt and penetrating neck trauma. BJA education. 2021;21(9):329-335.
9. Alsawair K, Alshehri AMR, Alshaya OMA, Alarjan AMR, Alruwaili SSB, et al. Interdisciplinary approaches in managing skeletal and viceral trauma: A comprehensive review. Revista iberoamericana de psicología del ejercicio y el deporte. 2024;19(6):664-671.
10. Ugwu CN, Ugwu OPC, Alum EU, Eze VHU, Basajja M, et al. Sustainable development goals (SDGs) and resilient healthcare systems: Addressing medicine and public health challenges in conflict zones. Medicine. 2025;104(7):e41535.
11. Mahmud H, Qaiser A, Sohail U, Bhutta MA. Morbid pediatric trauma: Our experience in a tertiary care hospital. Journal of Child Health Sciences. 2024.
12. Burback L, Brult-Phillips S, Nijdam MJ, McFarlane A, Vermetten E. Treatment of posttraumatic stress disorder: A state-of-the-art review. Current neuropharmacology. 2024;22(4):557-635.
13. Ceballo R, Cranford JA, Alers-Rojas F, Jocson RM, Kennedy TM. What happens after school? Linking Latino adolescents’ activities and exposure to community violence. Journal of youth and adolescence. 2021;50:2007-2020.
14. Olivier E, Morin AJS, Vitaro F, Galand B. Challenging the “‘Mean Kid”’Perception: Boys’ and Girls’ Profiles of Peer Victimization and Aggression from 4th to 10th Grades. Journal of interpersonal violence. 2022;37(17-18):NP15095-NP15129.
15. Guilherme AA, de Araujo JM, Silva L, de Oliveira Brito R. Two ‘Brazils’: Socioeconomic status and education performance in Brazil. International Journal of Educational Research. 2024;123:102287.
16. White KR, Rolock N, Marra L, Faulkner M, Ocasio K, Fong R. Understanding wellbeing and caregiver commitment after adoption or guardianship from foster care. Journal of Public Child Welfare. 2021;15(1):105-130.
17. Atim C, Koduah A, Kwon S. How and why do countries make universal health care policies? Interplay of country and global factors. Journal of Global Health. 2021;11:16003.
18. Forde S. The violence of space and spaces of violence: Peace as violence in unequal and divided spaces. Political Geography. 2022;93:102529.
19. Schwartz FW, Lee S, Darrah TH. A review of health issues related to child labor and violence within artisanal and small‐scale mining. GeoHealth. 2021;5(2):e2020GH000326.
20. Song A, Yoon Y, Cho Y. The association between polyvictimization in childhood and intimate partner violence and child abuse in adulthood. Journal of interpersonal violence. 2022;37(9-10):6009-6033.
21. Lansford JE, Godwin J, McMahon RJ, Crowley M, Pettit GS, et al. Early physical abuse and adult outcomes. Pediatrics. 2021;147(1).
22. Wangamati CK, Sundby J, Izugbara C, Nyambedha EO, Prince RJ. Challenges in supporting survivors of child sexual abuse in Kenya: A qualitative study of government and non-governmental organizations. Journal of interpersonal violence. 2021;36(15-16):NP8773-NP8799.
23. Syamsuddin R, Patra AAA, Fuady MIN, Nur M. The Family Impacts on Minors as Perpetrators of Acts of Terror: Evidence from Indonesia. PETITA. 2024;9:129.
24. Muniz CN, Powers RA, Leili JA. The influence of gender on perceptions of culpability and victim status in statutory rape offenses involving teachers. Sexual Abuse. 2021;33(5):529-551.
25. George AS. Exam season stress and student mental health: An international epidemic. Partners Universal International Research Journal. 2024;3(1):138-149.
26. Sarkar R, Ozanne-Smith J, Bassed R. Systematic review of the patterns of orofacial injuries in physically abused children and adolescents. Trauma, Violence, & Abuse. 2021;22(1):136-146.
27. Meng D, Chen J. Hearing Damage Through Blast. Explosive Blast Injuries: Principles and Practices. 2023;301-317.
28. Khorram-Manesh A, Burkle FM, Goniewicz K, Robinson Y. Estimating the number of civilian casualties in modern armed conflicts–a systematic review. Frontiers in public health. 2021;9:765261.
29. Kim C, Kabbani S, Dube WC, Neuhauser M, Tsay S, et al. Health equity and antibiotic prescribing in the United States: a systematic scoping review. Open Forum Infectious Diseases. 2023;109):ofad440.
30. Smith ER, Espinoza P, Metcalf M, Ogbuoji O, Cotache-Condor C, et al. Modeling the global impact of reducing out-of-pocket costs for children’s surgical care. PLOS Global Public Health. 2024;4(1):e0002872.
31. Lan CK, Gin O. Bao Ninh's Contribution to Vietnamese and World Literature:" The Sorrow of War" and his Short Stories. Taylor & Francis. 2024.
32 Anjana RM, Mohan V, Rangarajan S, Gerstein HC, Venkatesan U, et al. Contrasting associations between diabetes and cardiovascular mortality rates in low-, middle-, and high-income countries: cohort study data from 143,567 individuals in 21 … Diabetes Care. 2020;43(12):3094-3101.
33. Yuma-Guerrero P, Orsi R, Lee PT, Cubbin C. A systematic review of socioeconomic status measurement in 13 years of US injury research. Journal of safety research. 2018;64:55-72.
34. Mahdi SS, Allana R, Battineni G, Khalid T, Agha D, et al. The promise of telemedicine in Pakistan: a systematic review. Health Science Reports. 2022;5(1):e438.
35. Ogu JMC. Connecting Human Dignity, Non-Violence, and Environment for Healthcare Ethics in Nigeria. Duquesne University. 2021.
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