Abstract
Three cases of impalement injuries to the palate in children are described.
The first case; a 26-month-old boy was referred to the Division of Dentistry of Chiba Children's Hospital, due to oral hemorrhaging after he fell to the floor with a toy pipe in his mouth. A bleeding,25*35 mm laceration was seen in the mucosa of the hard palate. The wound needed over 10 stitches to close, with 4-0 VICRYL® under local anesthesia. The suture stitches were removed without any trouble after 17 days.
The second case; a 35-month-old boy fell down with a wooden chop stick in his mouth. The tip of the stick penetrated his soft palate into the nasal cavity. The stick was easily pulled out, and the palatal wound was sutured under local anesthesia. After 6 days, the 4-0 VICRYL® sutures were removed.
The third case; a 1-year-old boy was referred to us because of oral bleeding. He fell down while having the spout of a watering pot in his mouth. A semicircular-shaped wound of his soft palate with a diameter of 15 mm was found. The wound communicated with the nasal cavity. It was also possible to close this wound with sutures (4-0 VICRYL®) under local anesthesia.
For infants or children, under local infiltration anesthesia, the sutures of wounds in the oral cavity are very difficult to treat due to involuntary movement of the whole body and the tongue. It occasionally occurs to them to involve unexpected injuries or breakage or swallowing of the needle. However, the use of local anesthesia with appropriately surgical procedures could be recommended because the general anesthesia in infant or children has several disadvantages.
