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

2018 ◽  
Vol 100 (8) ◽  
pp. 632-634 ◽  
Author(s):  
S Morris ◽  
MS Osborne ◽  
AL McDermott

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.

1990 ◽  
Vol 4 (9) ◽  
pp. 599-602 ◽  
Author(s):  
Norman E Marcon

The most common article ingested in adults is food or food products such as nuts, shells, pits and bones. Poorly chewed steak causing bolus obstruction occurs especially in the elderly, while coins are most common in the pediatric group. New techniques of flexible endoscopy have altered and improved management, decreasing the need for surgery. A foreign body in the esophagus mandates prompt removal to avoid perforation. At least 80% of foreign, bodies reaching the stomach pass spontaneously. Once the foreign body is beyond the distal duodenum, it should be followed with serial x-rays. Techniques of removal of meat, bones, shells, bezoars, glass, bottle tops, sharps, pencils, pens, wires, thermometers, gastrostomy tubes, obesity balloons, safety pins, razor blades, button batteries and cocaine packets are described. Complications related to foreign body removal are rare.


2021 ◽  
pp. 019459982110083
Author(s):  
Arash R. Safavi ◽  
Christopher D. Brook ◽  
Osamu Sakai ◽  
Bindu N. Setty ◽  
Ann Zumwalt ◽  
...  

Objective Coin-shaped button battery foreign bodies have a similar initial presentation to coin ingestion, but delayed retrieval of a battery from the esophagus can have devastating consequences. Variations in timing of retrieval for children with ingestion of coin foreign bodies have been reported. The study assesses the sensitivity and specificity of conventional and digital radiographs to differentiate button batteries from coin foreign bodies. Study Design 3B case control study. Study Setting Tertiary academic medical center. Methods A radiographic study of the 12 most common commercially available button batteries and 66 coins of varying international origins was performed. Foreign bodies were placed at the cervical esophagus of a cadaver, and anteroposterior (AP) and lateral conventional radiographs of the neck were obtained. Digital AP and lateral radiographs of standalone coins and batteries were also obtained. Images were blindly read by 2 otolaryngologists and 2 radiologists. Statistical analysis was performed to determine accuracy in identifying coins vs batteries. Results Using conventional radiographs to identify button batteries yielded a sensitivity of 0.88 and a specificity of 0.92 (positive predictive value [PPV] = 0.75, negative predictive value [NPV] = 0.97). Digital radiography yielded an overall sensitivity of 0.98 and specificity of 0.97 (PPV = 0.87, NPV = 0.99). Features of button batteries were only seen on AP conventional radiographs using reverse contrast. Conclusions Neither conventional nor digital radiographic imaging had perfect accuracy in identifying coins vs batteries. Features of common disc batteries were identified, which may aid in diagnosis. With potential devastating consequences from retained battery in the esophagus, emergent removal of any possible disc battery foreign body should be considered.


2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
S Mahmood ◽  
M Mair ◽  
M Hussain ◽  
P Conboy

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.


Author(s):  
Gerald P. Sebastian ◽  
Rajinidevi Kaliyan ◽  
Pethuru Devadason

<p>In children the foreign bodies are a common occurrence which may be either accidental or self-induced as a matter of habit. Various materials like metal, plastic toy parts, food matters, etc have been reported as foreign bodies. Button batteries have been reported as foreign bodies in the ear, nose and throat are very relevant and practical, due to their early chemical disintegration in contact with mucosal surface; hence, need emergency surgical intervention to avoid complications. Here, we report five cases of button batteries in the ear nose and throat at various stages of presentation with their sequelae.</p>


Author(s):  
P D Chakravarty ◽  
T Kunanandam ◽  
G Walker

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.


2014 ◽  
Vol 129 (1) ◽  
pp. 93-94 ◽  
Author(s):  
W Nivatvongs ◽  
M Ghabour ◽  
G Dhanasekar

AbstractBackground:Removing a button battery from the ear can be a tricky and challenging procedure.Method and Results:We describe the innovative use of a magnetic telescopic rod to successfully remove a button battery from the ear canal of a nine-year-old boy.Conclusion:We propose that this equipment should be available in ENT clinics and operating theatres to be used for removing foreign bodies made from ferrous materials.


2014 ◽  
Vol 24 (02) ◽  
pp. 196-200
Author(s):  
Morteza Tahmasebi ◽  
Hamdollah Zareizadeh ◽  
Azim Motamedfar

Abstract Background and Objective: Detection of radiolucent soft-tissue foreign bodies is a challenging problem, which is especially further complicated when retained foreign body is highly suggested by clinicians but radiography is negative. So, blind exploration is sometimes hazardous for patients. The purpose of this study was to determine the accuracy of ultrasonography (USG) in detecting radiolucent soft-tissue foreign bodies in the extremities. Materials and Methods: From November 2011 to January 2012, patients with clinically suspected radiolucent soft-tissue foreign body and negative radiography were evaluated by USG with a 12-MHz linear array transducer. The patients with positive clinical and USG examination were included in our study and underwent exploration or USG removal. Results: Fifty-one patients underwent foreign body removal under ultrasonography-guided or surgical exploration and 47 patients had foreign body (31, 12, 3, and 1 case had thorn, wood, glass, and plastic, respectively). Ultrasound was positive in 50 patients. USG falsely predicted the presence of foreign body in four cases and was falsely negative in one of the cases. Accuracy, sensitivity, and positive predictive value were determined as 90.2%, 97.9%, and 92%, respectively. Conclusions: The real-time high-frequency USG is a highly sensitive and accurate tool for detecting and removing radiolucent foreign bodies which are difficult to be visualized by routine radiography.


2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Jian Cao ◽  
Baihua Chen ◽  
Yun Li

Purpose. To report a novel technique of cross-knotted suture basket and to test its effectiveness in large nonmagnetic intraocular foreign body (IOFB) removal. Methods. A 7/0 Vicryl suture was cut in half and cross-knotted, and four ends were introduced into a 23G needle to form a basket. Pig eyes were used to set up the IOFB model, and the effectiveness of the suture basket in the removal of large nonmagnetic intraocular foreign bodies was tested. Results. Several modifications can be made to adapt to different situations. For the materials (stone, metal, glass, and wood) and shapes (irregular, spherical, and rectangle) of large IOFB tested, the cross-knotted suture basket successfully removed all kinds of IOFBs. Conclusion. The suture basket technique provides an accessible, safe, and effective alternative in large nonmagnetic IOFB removal. It can be adapted and interchangedand also worth’s further clinical investigations.


2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Theophilus Adjeso ◽  
Michael Chanalu Damah ◽  
James Patrick Murphy ◽  
Theophilus Teddy Kojo Anyomih

Background. Foreign body (FB) aspiration requires a high index of suspicion for diagnosis and prompt management to avoid morbidity and mortality. This retrospective study was conducted to review pediatric foreign body aspiration at the Ear, Nose and Throat (ENT) Unit of the Tamale Teaching Hospital (TTH). Materials and Methods. The theater records of children managed for foreign body aspiration from January 2010 to December 2016 at the ENT Unit of TTH were retrieved and data summarized with respect to age, gender, indications for bronchoscopy, nature of foreign body, location of foreign body, and outcome of the bronchoscopy procedure. Results. A total of 33 children were managed within the five-year study period and comprised 16 (48.5%) males and 17 (51.5%) females. The commonly aspirated FBs were groundnuts (13, 39.4%) and metallic objects (7, 21.1%). The peak incidence occurred in children aged ≤ 3 years. The foreign bodies (FBs) were commonly localized to the right (24.2%) and left (24.2%) main bronchi, respectively. One patient had emergency tracheostomy for failed bronchoscopy. Conclusion. Groundnuts were the most commonly aspirated foreign body with most of the FBs localized in the bronchi.


2015 ◽  
Vol 2015 ◽  
pp. 1-3
Author(s):  
Merih Onal ◽  
Gultekin Ovet ◽  
Necat Alatas

Foreign bodies lodged in the upper airway are a common occurrence in children. Many unusual foreign bodies in the nose have been reported as foreign bodies like nuts, plastic toy parts, beads, and so forth. Most of these produce minimal morbidity but button batteries due to their early chemical disintegration require early surgical intervention. Here, we report a case of button battery lodged in the nose for several years with a symptom of nasal obstruction and chronic sinusitis.


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