Assessing the Ignored Associated Injuries of the Ear, Nose and Throat in Patients with Multiple Trauma in Shahid Rahnamun Hospital of Yazd in 2012 and 2013

BACKGROUND: Many trauma patients in the Emergency Department are unconscious, and this causes many other problems to go undiagnosed, resulting in the loss of valuable time in initiating the appropriate treatments. The purpose of this study was to determine the prevalence and types of injuries to the ears, nose, and throat that are ignored in patients with multiple traumas in an Emergency Department. METHODS: This study was conducted by assessing patients with multiple traumas who were admitted to the Emergency Department at Shahid Rahnamun Hospital in Yazd, Iran, in 2012 and 2013, and who were advised to acquire diagnostic workups and treatment in the Ear, Nose, and Throat Department. The patients' data were gathered by studying their records and by careful examinations, and the data were analyzed using the chi-squared test by SPSS version 18. RESULTS: Among the 230 patients who were counseled, 170 patients had multiple traumas that were caused by accidents, falls, conflicts between individuals, and natural disasters. Fifty-four patients with low Glassco Coma Scale (GCS) values who were admitted to the ICU were counseled after they regained consciousness. Among the 54 cases, 12 cases (22%) had nasal fractures and four cases had septal hematomas that resulted in infections and severe deformities. Twenty-four cases (44%) had lacerations of posterior auricular components, one case required extended debridement, and two cases had extensive necrosis that required a local flap. Two cases (3%) had paralyzed facial nerves, 8 cases (14%) had fractured mandibles, and 10 cases (18%) had laceration of the oral mucosa (lingual - buccal) that require extended debridement in the operating room. CONCLUSIONS: It is recommended that complete physical examinations be done in patients with multiple trauma after they are stabilized; such examinations would require careful training of the medical staff and also careful and timely counseling.