165 Impact of COVID-19 on management of Foreign Bodies in Otolaryngology

Abstract Aim The primary aim was to assess safety of Ear, nose and throat foreign body extraction during the coronavirus pandemic as this procedure is considered a potential aerosol generating procedure. The secondary aim was to evaluate the potential risks to patients if foreign body removal was delayed. Method A prospective study of 50 patients presenting to our unit with foreign bodies between March 2020 and August 2020 during the COVID-19 pandemic was performed. All patients were seen within 1 week of referral. The sites and types of foreign bodies were studied and correlated with complications where present. We assessed the circumstances under which foreign body removal was performed and its effect on health care professionals. Results The most common age group was the paediatric age group (52%). The most frequent sites of foreign bodies were the Ears at 78%(39 patients), followed by the nose at 12% (26 patients). Non-organic foreign bodies (52%) were more prevalent than organic foreign bodies (48%). Removal was performed in 31 (62%) patients either in clinic or in theatre. However, 19 patients (38%) were managed conservatively adhering to the British Association for Paediatric Otolaryngology guidance. Only 2 patients developed complications secondary to retained non-organic aural foreign bodies. None of the patients with organic foreign bodies developed complications. No infection rates among medical staff managing these patients were identified. Conclusions Contrary to normal practice, it is safe to manage selective ENT foreign bodies in a semi-urgent manner allowing time to implement ample precautions to reduce infection risks.

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Pattern of Ear Diseases among Paediatric ENT Patient: An Experience from Tertiary Care Centre, Pokhara, Nepal

Journal of Nepal Paediatric Society ◽

10.3126/jnps.v32i2.5673 ◽

2012 ◽

Vol 32 (2) ◽

pp. 142-145 ◽

Cited By ~ 2

Author(s):

B Sigdel ◽

R Nepali

Keyword(s):

Tertiary Care ◽

Age Group ◽

Care Centre ◽

Tertiary Care Centre ◽

Suppurative Otitis Media ◽

Ear Diseases ◽

Paediatric Age ◽

One Year ◽

A Prospective Study ◽

Nose And Throat

Introduction: Ear diseases are common in children mainly due to altered anatomy of Eustachian tube which is straighter in children as compared to that in adults. However, the cause of hearing loss in children is more varied, including the etiologies. This study was done to find out the pattern of ear diseases in paediatric age group attending ear, nose and throat OPD in a tertiary care centre in Pokhara, Nepal. Materials and Methods: This is a prospective study done in paediatric patients attending ENT OPD over a period of one year from January 2010 to January 2011. The diagnoses were made on the basis of history and clinical examination. Results were expressed in numbers and percentages. Results: Out of 1632 Pediatric ENT patients, 944 had ear diseases, 59.2% were males and 40.8% females. Wax (33.4%) was the commonest diagnosis followed by Chronic suppurative otitis media (24.3%) and Acute ottitis media (13%). Conclusion: Ear diseases are most common condition in ENT OPD among paediatric age group. Wax, CSOM and ASOM were the three most common ear diseases. J. Nepal Paediatr. Soc. 32(2) 2012 142-145 doi: http://dx.doi.org/10.3126/jnps.v32i2.5673

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Will children ever learn? Removal of nasal and aural foreign bodies: a study of hospital episode statistics

Annals of The Royal College of Surgeons of England ◽

10.1308/rcsann.2018.0115 ◽

2018 ◽

Vol 100 (8) ◽

pp. 632-634 ◽

Cited By ~ 1

Author(s):

S Morris ◽

MS Osborne ◽

AL McDermott

Keyword(s):

Foreign Body ◽

Foreign Bodies ◽

Hospital Episode Statistics ◽

Hospital Data ◽

Foreign Body Removal ◽

Hospital Episode ◽

Risk Of Injury ◽

Adults And Children ◽

Button Batteries ◽

Nose And Throat

Introduction Foreign body removal is a common reason for children to attend the emergency department. Generally, aural and nasal foreign bodies are not associated with immediate morbidity unless they are button batteries. There can be consequences of migration and removal. Methods Hospital Episode Statistics for 2010–2016 were used to calculate the number of nasal and aural foreign bodies that have been removed in hospital. Data for adults and children have been compared. Results 8752 nasal and 17,325 aural foreign bodies have been removed from adults and children over the course of 6 years. Children were responsible for 95% of the 8353 nasal and 85% of the 14,875 aural foreign body presentations. Children aged 1–4 years are most at risk of injury. Conclusion Children are more likely to present to hospital than adults with a foreign body in the ear or nose. Aural bodies were more likely to need removal in hospital for both populations. Authors believe that these require identification and removal by an ear, nose and throat specialist to prevent morbidity. The overall number of procedures performed annually in children has not reduced over the study period; an average of 1218 nasal and 2479 aural foreign body removals are performed each year with an annual cost of £2,880,148 to NHS England.

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Capsular dissection technique for reducing recurrent laryngeal neuropraxia and temporary hypoparathyroidism after thyroidectomy: a single center experience

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20212445 ◽

2021 ◽

Vol 7 (7) ◽

pp. 1111

Author(s):

Dimple Sahni ◽

Rajwant Kaur ◽

Gagandeep Kaur ◽

Sangeeta Aggarwal ◽

Sanjeev Bhagat

Keyword(s):

Foreign Body ◽

Foreign Bodies ◽

Single Center ◽

Single Center Experience ◽

Clinical Presentations ◽

Life Threatening ◽

High Index Of Suspicion ◽

A Prospective Study ◽

Dissection Technique ◽

Nose And Throat

Background: Foreign bodies in aerodigestive tract is common, frequent, and sometime life threatening emergency for otorhinolaryngologists mainly in the paediatric group. The aims of the present study was to find the incidence of foreign bodies, in relation to demographic factors, type and sites of foreign bodies its clinical presentations and its management.Methods: A prospective study was conducted on 100 cases coming to the ear, nose and throat (ENT) emergency and outpatient department (OPD). After thorough history, clinical examination, routine blood and urine investigations and urine done. Radiological examination was done to visualize the radio-opaque foreign body, and if the foreign body was not radio-opaque then computed tomography (CT) scan was done. Results: Incidence of foreign was 67% in male than 33% in female. Mostly foreign bodies were in nose (49%), followed by oesophageal (31%), abdominal (14%), and bronchus (6%) respectively. 33% were totally asymptomatic, 25% with mucupurulent discharge from nose, dysphagia (16%), nasal obstruction (15%), and odynophagia (11%) respectively. Most of the foreign bodies were inorganic in nature, coin (42%), pearls (8.16%), and battery (6.45%). Among organic foreign bodies peanut was most common (33.33%), grains (10%). All foreign bodies were removed successfully with minimal morbidity and zero mortality.Conclusions: Present study suggested incidence was very common among male children, in rural background, with common asymptomatic presentation. With high index of suspicion, and proper and timely intervention all 100 cases were managed successfully. But still educating the parents about keeping such things away from kids prevent these incident.

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Panorama of foreign body in upper digestive tract in the population of Uttarakhand

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20190772 ◽

2019 ◽

Vol 5 (2) ◽

pp. 416

Author(s):

Chetan Bansal ◽

Prerana Bharti ◽

V. P. Singh

Keyword(s):

Foreign Body ◽

Digestive Tract ◽

Foreign Bodies ◽

Clinical Presentation ◽

Medical Emergency ◽

Age Group ◽

Common Site ◽

Sex Type ◽

Type Site ◽

A Prospective Study

Background: Foreign body aspiration is more common in children than adults because they explore the world with their hands and mouth and also have incomplete control and immature judgment. Foreign bodies in ENT are a medical emergency as their removal demands great skill due to unpredictability in the procedure and the complications associated with it.Methods: A prospective study was conducted on 40 cases of digestive tract foreign bodies in relation to age, sex, type, site, clinical presentation, extraction and complications. Results: Youngest child was 5 months old. Most predisposed age group was 0-5 years (60% of cases). Cricopharynx (24 cases) was the most common site of impaction for foreign body. In the present study toys (22.5%) were most common foreign bodies followed by coins (15%) ingestion.Conclusions: Avoid carelessness. Avoid hasty drinking, eating, talking and running with anything in the mouth. Keep the things out of reach of the children. Be particular in sleep, anesthesia, coma or delirium. Avoid putting objects into mouth.

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Upper gastro intestinal foreign bodies in pediatrics patients

Journal of Health and Allied Sciences NU ◽

10.1055/s-0040-1703933 ◽

2015 ◽

Vol 05 (04) ◽

pp. 040-044

Author(s):

Venkatesh M. Annigeri ◽

Bahubali D. Gadgade ◽

Rashmi V. Annigeri ◽

Anil B. Halgeri

Keyword(s):

Foreign Body ◽

Digestive Tract ◽

Foreign Bodies ◽

Major Complication ◽

Esophageal Disease ◽

Age Group ◽

Magill Forceps ◽

Upper Digestive Tract ◽

Flexible Esophagoscopy ◽

A Prospective Study

Abstract Aim: Analyzeexperience with presentation, diagnosis and management of accidental ingested upper digestive tract foreign bodies in children. Materials: A prospective study of 60 pediatric patients from July 2009 to July 2014 with history of accidental ingested upper gastro intestinal foreign bodies. All patients were studied for age, gender, complaints, duration, site of impaction, type and complications. Radiological investigations were taken according to the case. Direct laryngoscopy and Magill forceps or flexible esophagoscopy has been used for retrieval of foreign bodies. Result: Sixty cases were analyzed age between 6 months to 13 years. Male 42 and female 18. Age group 6 months to 6 years constitutes 85%. Thirty six (60%) patients arrived to hospital within 24 hours. Difficultly in swallowing (70%) was the most frequent symptom. Most foreign bodies were coin in the upper esophagus (70%). Preexisting esophageal disease was present in 20%. Out of 60 patients twenty four (40%) FB retrieved using Magill forceps and rest with Flexible esophagoscopy (60%). Foreign bodies were successfully removed without major complication in all cases. Mucosal erosions were seen in four patients after extraction. All patients except 4 were discharged within 24 hours after the procedure. Conclusion: Children between 6 month to 6 years is the commonest age group affected. Magill forceps with the aid of a direct laryngoscope is a safe and effective method for proximal esophageal foreign body removal. But flexible esophagoscopy remains the safest method of upper digestive tract foreign body extraction.

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Challenges in treating patients with foreign bodies in hypopharynx and esophagus: our experience in a tertiary care hospital

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20213902 ◽

2021 ◽

Vol 7 (10) ◽

pp. 1660

Author(s):

Nambiar Sapna S. ◽

Swathilal S. A. ◽

Sunilkumar K. P. ◽

Soumya Aravind M. V.

Keyword(s):

Foreign Body ◽

Esophageal Perforation ◽

Foreign Bodies ◽

Tertiary Care ◽

Care Hospital ◽

Foreign Body Removal ◽

Rigid Endoscopy ◽

Sudden Decrease ◽

High Index Of Suspicion ◽

A Prospective Study

Background: Foreign bodies (FBs) of the hypopharynx and esophagus are among the common otolaryngologic emergencies. Every new case poses a clinical challenge with need for optimal treatment strategy. The objective of our study is to highlight a few of the challenges faced while treating these patients.Methods: A prospective study was done on all patients who reported to the ENT casualty, Government Medical College Kozhikode with history or suspicion of foreign body throat from January 2020 to January 2021. A total of 160 patients reported of which 48 (30%) patients required further evaluation with rigid endoscopy and foreign body removal in the operative room. A few challenges like migration of foreign bodies, dilemma in diagnosis with FB mimicking ossified cartilages on X-ray, FB removal in mentally challenged patients and treatment of esophageal perforation post rigid endoscopy are discussed.Results: Only 48 (30%) patients of the total 160 patients required rigid endoscopy and foreign body removal in the operating room. The foreign body was obtained in 42 (87.5%) patients while 6 (12.5%) patients improved post rigid endoscopy though foreign body was not obtained. One patient with denture in the esophagus developed esophageal perforation requiring prolonged hospital stay.Conclusions: A high index of suspicion among patients presenting with dysphagia, neck pain and sudden decrease in food intake is warranted. Early diagnosis with appropriate imaging modalities is essential for confirmation of diagnosis. Dentures are among FBs that necessitate more caution. Esophageal perforation, a rare but life-threatening complication must be diagnosed timely with appropriate surgical intervention.

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Intriguing aural foreign body and algorithm of management of foreign body

BMJ Case Reports ◽

10.1136/bcr-2021-242122 ◽

2021 ◽

Vol 14 (8) ◽

pp. e242122

Author(s):

Komalar Ponnuvelu ◽

Jeyasakthy Saniasiaya ◽

Norhaslinda Abdul Gani

Keyword(s):

Foreign Body ◽

External Auditory Canal ◽

Care Setting ◽

Adult Patients ◽

Deep Penetration ◽

Acute Care Setting ◽

Age Group ◽

Paediatric Age ◽

Nose And Throat ◽

Tree Stem

Foreign body (FB) in the external auditory canal is more common among the paediatric age group compared with adult patients and it may be deposited in various ways. An accidental animate aural FB is reported to be commonly encountered in adults whereas inanimate FBs are likely to be found among adult patients with learning disability. An elderly man presented with accidental penetration of rattan tree stem into his ear while gardening. Removal of a FB from the external auditory canal requires expertise as deep penetration of a FB into the middle and inner ear may lead grave complications, especially when overzealous removal is attempted by nonear, nose and throat (ENT) personnel. This case emphasises on the importance of awareness of meticulous removal of a FB under proper visualisation so as to avoid unnecessary complications. Additionally, we propose an algorithm for proper removal of aural FB in an acute care setting.

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CLINICAL AND PARACLINICAL CHARACTERISTICS AND RESULTS FROM TREATMENT OF FOREIGN BODIES INGESTION

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2016.4.10 ◽

2016 ◽

pp. 63-69

Author(s):

Hoang Cuong Vo ◽

Thanh Dang ◽

Phuong Nam Tran ◽

Thanh Thai Le

Keyword(s):

Foreign Body ◽

Clinical Characteristics ◽

Foreign Bodies ◽

University Hospital ◽

Age Group ◽

Central Hospital ◽

Results Of Treatment ◽

Rigid Esophagoscopy ◽

Flexible Esophagoscopy ◽

Esophageal Foreign Bodies

Background: Foreign bodies ingestion is a emergency in otology, knowledge of people about foreign bodies ingestion is not enough. Objective: To study the clinical characteristics, paraclinical characteristics and results of treatment from foreign bodies ingestion in Hue Central Hospital and Hue University Hospital. Methods and patiens: A cross descriptive and prospective study over the period from 6/2014 to 5/2016, total are 137 patients come to be diagnosised and treatmented. Results: the average age is 35 years old. Gender: male (51.8%) and women (48.2%). Adults (84.7%) having more than children (15.3%). Age group from 16-30 years is highest (32.8%). There are 95.7% of organic foreign bodies, 4.3% are inorganic foreign bodies. There are 90.5% of patients on diagnosis and treatment in stages less inflammation, arthritis 8.0% in the period and 1.5% in the period complications. Foreign body in the throat problems (73.7%), esophageal foreign bodies (26.3%). Pick up directly foreign bodies 54%, indirectly by the mirror 11.7% and endoscopy 8%, rigid esophagoscopy is 17.5%, flexible esophagoscopy is 7.3%, cervicotomy is 1.5%. Conclusion: Practing direction with in the oropharynx foreign body, using the larynx mirror or endoscopy with in the laryngopharynx for the esophagus foreign bodies, rigid esophagoscopy is better. Key words: Foreign bodies ingestion

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Issues of geriatric otolaryngologic emergency have not been widely applied despite increase in geriatric population. (Preprint)

10.2196/preprints.13383 ◽

2019 ◽

Author(s):

Waheed Atilade Adegbiji ◽

Shuaib Kayode Aremu ◽

AbdulAkeem Adebayo Aluko

Keyword(s):

Foreign Body ◽

Head And Neck ◽

Clinical Features ◽

University Teaching ◽

Age Group ◽

Geriatric Population ◽

Female Ratio ◽

Common Diagnosis ◽

Foreign Body Impaction ◽

Nose And Throat

BACKGROUND Issues of geriatric otolaryngologic emergency have not been widely applied despite increase in geriatric population. OBJECTIVE This study aimed at determining prevalence, sociodemographic features, aetiology, clinical features, Complications and sources ofreferral of geriatric otorhinolaryngological, head and neck emergency in our center. METHODS This was a prospective hospital based study of geriatric otorhinolaryngology emergency in the Ear, Nose and Throat Department of Ekiti State University Teaching Hospital. The study was carried out between October 2016 and September 2018. Data were obtained by using pretested interviewers questionnaire.All data were collated and analyzed using SPSS version 18.0. The data were expressed by frequency table, percentage, bar charts and pie charts. RESULTS Geriatric otorhinolaryngology, head and neck emergency accounted for 5.3%. Major prevalence age group was 43.9% in the age group (60-64). There were 38.6% males with male to female ratio of 1:1.5. The main aetiology of geriatric otorhinolaryngology emergency was 29.5% trauma/road traffic accident/foreign body impaction and 25.8% tumour. Main anatomical distribution of geriatric otorhinolaryngology emergency were 38.6% throat diseases and 31.1% ear diseases. The most frequent clinical features were pain in 27.3%, hearing loss in 21.2%, tinnitus in 15.9%, bleeding in 14.4%, difficulty breathing in 12.9% and discharge in 11.4%. Common diagnosis in this study were 15.9% sinonasal tumour, 14.4% upper aerodigestive foreign body impaction, 10.6% earwax impaction and 19.8% otitis externa. Acute presentation (<13 weeks) occurred in 1 week in 74.2% and 2-13 weeks In 19.7%. Commonest time of presentation was daytime in 65.9%. Major sources of referral were 43.2% general practitioner and 31.1% casualty officers. Presentation of geriatric otorhinolaryngology emergency were mainly ear, nose and throat clinic in 59.8% with accident and emergency in 28.8%. Commonest associated comorbid illnesses among the geriatric patients were 18.2% hypertension, 14.4% arthritis and 9.8% diabetes mellitus. CONCLUSIONS Geriatric otorhinolaryngological emergency are common pathology with associated with comorbid illnesses. Detailed clinical assessment are mandatory for effective management outcome.

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How we do it: impacted oesophageal foreign body removal using a dilatation balloon

The Journal of Laryngology & Otology ◽

10.1017/s002221512100178x ◽

2021 ◽

pp. 1-3

Author(s):

P D Chakravarty ◽

T Kunanandam ◽

G Walker

Keyword(s):

Foreign Body ◽

Granulation Tissue ◽

Foreign Bodies ◽

Fluoroscopic Guidance ◽

Tertiary Referral ◽

Foreign Body Removal ◽

Novel Technique ◽

Common Presentation ◽

Reproducible Technique ◽

Rigid Oesophagoscopy

Abstract Background Ingested foreign bodies are a common presentation to paediatric ENT services. Depending on the site, these are usually managed with flexible or rigid oesophagoscopy and retrieval. This paper presents a novel technique for removing a hollow foreign body that could not be removed using conventional means. Method and results After rigid and flexible approaches failed, a guidewire was passed through the foreign body under fluoroscopic guidance and a dilatation balloon passed through the lumen of the object. Inflating the balloon allowed dilatation of the inflamed mucosa above and below the object, facilitating straightforward removal under traction. Conclusion This is a novel and reproducible technique that uses equipment readily available in tertiary referral centres. Employed in this context, the technique enabled removal of an impacted object surrounded by granulation tissue, and would be appropriate for other objects with a lumen.

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