Oropharyngeal trauma physical assessment and suggested imaging

Finding	Minor	Moderate	Severe
Mechanism	Low force: eg, Fall from the sitting position with toy in the mouth	Intermediate force: eg, Fall while running with pencil in mouth OR Bicycle accident while eating a popsicle	High force: eg, High speed motor vehicle accident with impaling oropharyngeal object OR Penetrating injury with knife or gunshot wound
Wound appearance	Mucosal laceration <2 cm in length OR Superficial midline puncture wound	Submucosal laceration >2 cm in length OR Tonsillar or lateral soft palate deep or indeterminate depth puncture wound OR Protruding or retained foreign body*	Large, gaping wound with copious bleeding OR As for moderate injury with associated neurovascular findings
Associated findings	Superficial gum laceration or abrasion	Tooth fracture, luxation, or avulsion Tongue laceration Jaw fracture	Neurologic abnormality carotid artery bruit on side of injury
Radiographic imaging	Not indicated	CTA or contrast enhanced MRA^¶	Digital subtraction CAA

CTA: computed tomography angiography; MRA: magnetic resonance angiography; CAA: carotid artery angiogram.

* A protruding oropharyngeal foreign body should only be removed in the operating room.

¶ Contrast enhanced MRA is preferred if available and if the patient can cooperate with not moving for 30 to 60 minutes.

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