What are the implications of a soft palate injury?

From the Guidelines

For a soft palate injury, immediate management includes rest, cold liquids, and soft foods for 24-48 hours to minimize discomfort and promote healing, as the soft palate is highly vascular and has a rich nerve supply, which can lead to significant bleeding and pain if deeply injured 1. When managing a soft palate injury, it is essential to prioritize the patient's comfort and promote healing. The soft palate plays a crucial role in swallowing, and any injury to this area can lead to complications such as dysphagia, aspiration pneumonia, and malnutrition 1. Some key considerations for managing a soft palate injury include:

• Taking acetaminophen (500-1000mg every 6 hours) or ibuprofen (400-600mg every 6-8 hours with food) for pain relief
• Rinsing with warm salt water (1/2 teaspoon salt in 8oz warm water) several times daily to keep the area clean
• Seeking medical attention if you experience severe pain, difficulty breathing or swallowing, significant bleeding that doesn't stop, signs of infection (increasing pain, swelling, fever), or if the injury doesn't improve within a few days The soft palate's abundant blood supply and rich nerve supply explain why these injuries can be quite painful despite their typically benign nature 1. Deeper or more extensive injuries may require medical evaluation to rule out complications or the need for surgical repair. In some cases, such as those with underlying neurological disorders, the risk of complications from a soft palate injury may be higher, and close monitoring and management may be necessary to prevent aspiration pneumonia, malnutrition, and other complications 1. Overall, the management of a soft palate injury should prioritize the patient's comfort, promote healing, and prevent complications, with a focus on rest, pain relief, and close monitoring for signs of infection or other complications 1.

From the Research

Causes of Soft Palate Injury

• Impalement injuries of the soft palate and oropharynx are common in children, especially those of preschool age, often due to falls while carrying objects in their mouths 2
• Soft palate injury can also occur during orotracheal intubation with the videolaryngoscope, particularly when the intubator is focused on the video monitor and blindly inserts the Glidescope into the oropharynx 3
• Penetrating injuries of the soft palate can occur in the pediatric population, with the majority being minor and requiring only conservative treatment 4

Management of Soft Palate Injury

• Most impalement injuries of the oral cavity in children can be treated conservatively, without surgical intervention, but careful assessment by an experienced clinician is necessary to rule out other complications 2
• Soft palate injuries during orotracheal intubation with the videolaryngoscope can be managed with primary closure for perforations or conservative treatment for lacerations, with antibiotics considered for lacerations greater than 1 to 2 cm 3
• Reconstruction of the soft palate defect can be achieved with a speech aid prosthesis, which can improve nasal emission during speech and prevent nasal regurgitation of food 5

Evaluation and Complications

• Clinical factors such as age, sex, mechanism of injury, site of injury, wound severity, and otolaryngology consultation can influence medical decision making in children with oropharyngeal trauma 6
• The likelihood of a patient undergoing computed tomographic angiography (CTA) to rule out occult internal carotid artery damage is increased with injury to the lateral soft palate, high wound severity score, and otolaryngology consultation 6
• Carotid injury can occur as a complication of soft palate injury, usually secondary to blunt trauma, and can result in neurologic deterioration 4