title: Outcomes in pediatric patients with recreational vehicle related forceful head impact.
abstract: OBJECTIVE
  To compare outcomes in pediatric patients suffering forceful head impact during recreational vehicle use to patients with forceful head impact from other mechanisms.
  
  
  METHODS
  Retrospective cohort study of all patients 3-18 years old who suffered forceful head impact (any traumatic mechanism strong enough to result in a face or skull fracture) in our institutional trauma registry between January 2011 and September 2013.
  
  
  RESULTS
  Out of 252 events involving forceful head impact, 64 events were a result of riding a recreational vehicle. Although there is no difference in rates of temporal bone fractures, recreational vehicle accidents have higher rates of otic capsule violation (21% vs. 5%) and higher rates of hearing loss (30% vs 16%) compared to patients with forceful head impact from other mechanisms. All incidents of otic capsule violation and sensorineural hearing loss in recreational vehicle accidents were associated with a temporal bone fracture.
  
  
  CONCLUSIONS
  Despite the increasing use of head protective gear while operating a recreational motor vehicle there is still heightened risk for temporal bone fractures and subsequent hearing loss. The comparative associations in this study suggest that helmets used with recreational vehicles do not protect the temporal bone thus leaving vital structures within the otic capsule at risk for damage and long term consequences. When treating these patients Otolaryngologists should be aware of the elevated risk of otic capsule violation and late hearing loss with temporal bone fractures.
authors.affiliation: The Ohio State University College of Medicine, Nationwide Children's Hospital, Columbus, OH, United States.
authors.forename: Cameron C
authors.initials: CC
authors.lastname: Sheehan
authors.affiliation: The Ohio State University College of Medicine, Nationwide Children's Hospital, Columbus, OH, United States; Department of Pediatric Otolaryngology, Nationwide Children's Hospital, Columbus, OH, United States.
authors.forename: Meredith
authors.initials: M
authors.lastname: Lind
authors.affiliation: The Ohio State University College of Medicine, Nationwide Children's Hospital, Columbus, OH, United States; Center for Surgical Outcomes Research, Nationwide Children's Hospital, Columbus, OH, United States.
authors.forename: Justin B
authors.initials: JB
authors.lastname: Mahida
authors.affiliation: The Ohio State University College of Medicine, Nationwide Children's Hospital, Columbus, OH, United States; Department of Pediatric Otolaryngology, Nationwide Children's Hospital, Columbus, OH, United States.
authors.forename: Garth
authors.initials: G
authors.lastname: Essig
authors.affiliation: Center for Surgical Outcomes Research, Nationwide Children's Hospital, Columbus, OH, United States; Department of Pediatric Otolaryngology, Nationwide Children's Hospital, Columbus, OH, United States. Electronic address: charles.elmaraghy@nationwidechildrens.org.
authors.forename: Charles A
authors.initials: CA
authors.lastname: Elmaraghy
mesh_terms: D000059:Accidents; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D005260:Female; D006260:Head Protective Devices; D006319:Hearing Loss, Sensorineural / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D008297:Male; D015541:Off-Road Motor Vehicles; D009820:Ohio / Q000453:epidemiology; D012042:Registries; D012189:Retrospective Studies; D012887:Skull Fractures / Q000453:epidemiology / Q000209:etiology; D013701:Temporal Bone / Q000293:injuries
keywords: All-terrain vehicles; Hearing loss; Helmet use; Injury prevention; Pediatrics; Trauma registry