Assault Related Otorhinolaryngology Head And Neck Injuries In Children And Adolescents: A Prospective Study From A Tertiary Health Institution In Southwestern Nigeria.

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.