Management of Foreign Bodies in the Ear, Nose and Throat in Pediatric Patients: Real-Life Experience in a Large Tertiary Hospital

Abstract

Background: Foreign body (FB) injuries occur frequently in children. The aim of this paper is to provide an update on the experience of the Department of Otolaryngology, San Camillo Forlanini Hospital in Rome concerning the management of FB injuries in children.Methodology: This study was carried out by collecting data from the medical reports of our Pediatric Emergency Room stored between 2007 and 2021. Inclusion criteria were diagnosis of FB in pediatric patients based on the ENT evaluation. Pediatric patients included children and preteens ranging from six months to 15 years.Results: Between 2007 and 2021, 1,623 cases of FBs in young patients (840 males, 783 females, mean age: 5.5 years) were observed at the Pediatric Emergency Room and treated by the ENT Department. The ear was the most frequently involved site (700 patients), followed by the nose (517 cases), pharynx (319 cases), mouth (76 patients) and airways (11 cases). The most common management strategy was FBs' removal in the emergency room and home discharge (1,409 patients), 99 cases required outpatient discharge, 64 patients moved away from the Emergency Care refusing treatment, 35 patients were hospitalized, 10 patients refused hospitalization, five were transferred to the pediatric hospital and one died in the emergency room.Conclusions: A quick diagnosis of FB followed by an effective removal is crucial to avoid injuries and complications. Surveillance registries have a key role in the prevention and management of FB injuries. Moreover, it is necessary to train medical and nursing staff of emergency, pediatric and otolaryngologist departments to best recognize and manage FB injuries.

Ear, nose and throat foreign bodies in the pediatric age. An experience in a quaternary care hospital in Maputo, Mozambique

“…Similar to another's studies [10,12], the ear FB was the most found in our study and include, seeds, grains, dolls eyes, erases, parts of plastic toys, cotton swabs, pebbles, sponges, beads typically African hairstyles and animated FB such as insects, cockroaches, larvae, etc. Occasionally it may be asymptomatic and found incidentally during routine ear examination or may have otalgia, pruritus, otorrhea, otorrhagia, tinnitus and hypoacusis.…”

“…Like other studies [11,12], males were the most affected, probably due to the more adventurous and curious spirit of this gender.…”

“…Occasionally it may be asymptomatic and found incidentally during routine ear examination or may have otalgia, pruritus, otorrhea, otorrhagia, tinnitus and hypoacusis. The ear was the most affected probably because, unlike the airways, the FB in this location, does not evoke protective reflexes such as coughing, vomiting, or sneezing [12] and not produce dyspnea.…”

Analysis of foreign bodies in the ear, nose, and throat in pediatric patients: Second level hospital experience in the Eastern Anatolia Region

“…Önemli mortalite ve morbidite nedeni olabilen YC aspirasyonları bir yaşın altındaki çocuklarda üçüncü, üç yaşın altındaki çocuklarda ise dördüncü ölüm nedeni olarak bildirilmiştir. [4] Kulak burun boğaz YC olgularının en sık üç yaşta olmak üzere özellikle beş yaşın altındaki çocuklarda görüldüğü bildirilmiştir, bunun nedeni ise erken çocukluk döneminde çocukların çevrelerinde buldukları nesneleri keşfetme amacıyla kulak, burun ve boğazlarına yerleştirme eğiliminde olmaları ve yürümeyi öğrendikten sonra YC'ye ulaşmalarının daha kolay olmasıdır. Yaş ortalaması birçok çalışmada kulakta YC olanlarda burun ve boğazda YC olanlara kıyasla daha yüksek bulunmuş ayrıca YC olgularının erkek cinsiyette görülme sıklığının daha çok olduğu rapor edilmiştir.…”

Assessment of Knowledge, Attitude, and Practice of First Aid Management of Choking Among Primary School Teachers in Riyadh, Saudi Arabia: A Cross-Sectional Study

“…As a matter of fact, foreign body ingestion and aspiration cause a considerable amount of morbidity and mortality because of choking; it is the fourth most common cause of unintentional death in children under three and the third youngest among those under one year old [ 15 ].…”