Impaled trans-palatal crochet needle impacted at skull base; a multidisciplinary management challenge.


  • Nadeem Ahmed Sheikh Combined Military Hospital, Jhelum Cantonment.
  • Khalid Pervaiz Butt Combined Military Hospital, Lahore.
  • Zahid Hussain Combined Military Hospital, Rawalpindi.



Computed Tomography Angiography, Foreign Bodies, Jugular Foramina, Oropharynx, Vertebral Artery, Wounds and Injuries


Pediatric oro-pharyngeal trauma is a common observation in hospital accidents & emergencies reception. Immense responsibility rests with specialized health care providers to instantly diagnose and manage a rather small proportion of life-threatening complication associated with such injuries. Postero-lateral oropharyngeal trauma carries a significant risk of major neurovascular insult. More-over such patients are exposed to high radiation exposure to face, head & neck regions. A multi-disciplinary approach involving high dependency nursing, neuro-observation, meticulous imaging, prompt surgical exploration where indicated and a cautious follow-up must be considered as neurovascular manifestation may become apparent after some days of initial injury.

Author Biographies

Nadeem Ahmed Sheikh, Combined Military Hospital, Jhelum Cantonment.

MBBS, MCPS, FCPS, CHPE, Assistant Professor & Head ENT, Classified ENT Specialist, 

Khalid Pervaiz Butt, Combined Military Hospital, Lahore.

MBBS, FCPS (Gen Surg), FCPS (Vascular Surg), CHPE, Assistant Professor, Classified General & Vascular Surgeon, 

Zahid Hussain, Combined Military Hospital, Rawalpindi.

MBBS, FCPS (Gen Surg), FCPS (Neurosurg), CHPE Advisor Neurosurgery, Assistant Professor, Classified Neurosurgeon,