Medico-legal Aspects of Otorhinolaryngeal, Face and Neck Injuries in Upper Egypt: A Prospective Analysis and Retrospective Evaluation of Claimed Disabilities

Omran, Ghada Ali; Ragaey, Mahmoud Ali; El Shehaby, Doaa M.

doi:10.21608/ejfsat.2019.14358.1082

Medico-legal Aspects of Otorhinolaryngeal, Face and Neck Injuries in Upper Egypt: A Prospective Analysis and Retrospective Evaluation of Claimed Disabilities

Document Type : Original Article

Authors

¹ Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Assiut University, Egypt

² Ear, Nose, Trachea department

³ Forensic Medicine and Clinical Toxicology Department, Faculty of medicine, Assiut University, Egypt

10.21608/ejfsat.2019.14358.1082

Abstract

Background: Trauma to the ear, nose, throat and face regions is of medicolegal importance as these regions are vulnerable to injury and often associated with mortality and varying degrees of physical, functional and psychological damages. The long-run complications may raise medicolegal claims in the court proceeding. Objectives: to assess the medicolegal aspects of otorhinolaryngeal (ORL) trauma cases alongside a retrospective evaluation of alleged long-term complications or disabilities following those types of injuries. Patient & Methods: The study included two parts. A descriptive cross-sectional, prospective part included 100 cases of ORL trauma who attended the ENT (Ear, nose and throat) department of Assiut University Hospitals, Upper Egypt during a one-year period. A second retrospective part included all (60) referred cases for ENT consultancy to confirm or deny the medicolegal claims of associated infirmities or disfigurements during the period from 2014 to 2017. Results: The examined presented cases were of mean age 21.43±12.4 years with male predominance. Road traffic accidents (ART) were the main mechanism of injury (44%) followed by violent assaults (23%), fall from a height (22%), and lastly firearm injuries (11%). Unintentional trauma was the commonest manner for injuries infliction followed by homicidal attacks. The nose was the commonest site of injury followed by ear, then neck and throat regions. Most cases had simple wounds with only one fatal case. Permanent infirmity was expected to be the fate only in 4% of the presented cases. The retrospective analysis revealed that the patients were of a mean age 41.8±1.4 years with male predominance as well. Violent assaults were the commonest cause of claimed disabilities and sensorineural hearing loss was the main reported complication, followed by nasal deformities. False patients’ allegations were unexpectedly the highest percentage reported while; true claims were the second common outcome, mainly in cases with nasal deformity. Conclusions: The present study addressed a differential pattern of prospectively presented ORL injuries, and retrospective associated disabilities or long-term complications. Early careful diagnoses and proper treatment can prevent deformity and permanent infirmity following ORL injuries. Further, a good knowledge of the legal implications of ORL associated complications can exclude fabricated claims.

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