Traditional game of spinning top gone wrong: Short communication of a pediatric facial penetrating injury

Abstract

Introduction A spinning top is a traditional game in some countries. The top is often made of wood or mud and the bottom is made of a sharp metal pin. Penetrating injuries can occur if the spinning top is incorrectly thrown. Case report We report a spinning top penetrating injury on the nose of an 8-year-old girl. Clinical examination revealed a spinning top that had penetrated her nasal bridge. Plain computed tomography (CT) of paranasal sinuses revealed a spinning top with its sharp pointed nail penetrating through the left nasal bone into the left nasal cavity. Examination under general anesthesia and rigid nasoendoscopy showed the tip of spinning top situated in between middle turbinate and nasal septum. The spinning top was then removed following the direction of entry. Discussion While air gun pellet facial injuries in pediatric patients have been reported, other playthings as culprits of facial penetrating injuries is still unheard of. Projectile objects can easily penetrate pediatric facial skeleton due to thinner facial bones. It is vital to exclude life- and sightthreatening injuries first, followed by imaging to assist decision-making and surgical planning. Computed tomography (CT) imaging is the gold standard for the radiographic evaluation of facial injuries. It assists in evaluating trauma extent, trajectory, depth, and course of foreign body. Following that, examination under anaesthesia including rigid nasal endoscopy is warranted. Conclusion We would like to highlight the importance of parental supervision and the value of pre-operative imaging. Neglecting seemingly harmless children’s toys can potentially cause fatal injuries.