Nasal Trauma Among Neonatal Intensive Care Unit Patients: A Retrospective Single Center Experience.

Background: Nasal trauma resulting from non-invasive ventilation in neonates admitted to intensive care units is a commonly underestimated complication. Objectives: To measure the incidence, risk factors, and severity of nasal trauma among pediatric patients admitted to intensive care units. Methods: A retrospective cross-sectional study was performed. Consultations and referrals by intensive care unit physicians to the otolaryngology department at a tertiary children's hospital in Dammam, Saudi Arabia, from April 2019 through October 2023 were reviewed. All patients with documented nasal trauma were eligible. External nasal examinations and anterior nasal endoscopy (0° telescope) with documentation of findings were performed on each patient. Results: The cumulative incidence of nasal trauma among ENT referrals was 10.7%. Males predominated (58%), with a median birth weight of 1.38 kg. NIPPV was the most common ventilation type (79%), and adhesions were the most common trauma (58%). The median duration on CPAP/NIPPV before trauma was 15 days. Medical management included topical ointments and saline rinses (37%), while surgical release was performed in 21% of patients; 42% received no intervention. Conclusion: Nasal trauma is relatively common among neonates requiring non-invasive ventilation in NICU settings. Multi-center studies with larger samples are recommended to better estimate incidence and improve preventive strategies.