Management of pediatric patients with foreign bodies in the ENT area

Introduction:

Foreign bodies in the ENT area of children are common and potentially life-threatening. The decision for or against a surgical intervention is often difficult to take as the causative event has usually been unobserved and symptoms are nonspecific.

Material and Methods:

For this descriptive retrospective study, we reviewed the management of all pediatric patients (aged 0 to 18 years) with a suspected foreign body in ear, nose and the upper or lower airway system from January 2012 to December 2016 at the ENT department of Ulm University. Data were analyzed with respect to patients age, indication for intervention and associated complications.

Results:

Extracted data included 530 patients (mean age 5,6 years). In most cases (396 patients) foreign body was found in the upper and lower airway system and in the oesophagus. 124 cases were managed via surgical intervention, 50 of them by rigid tracheobronchoscopy and/or oesophagoscopy. The correlation between chest X-ray and intraoperative findings was mostly insufficient. 50% of patients who underwent rigid tracheoscopy/oesophagoscopy visited the hospital after 08.00 p.m. There were no events of death or permanent morbidity in this series.

Conclusion:

Aspiration or ingestion of foreign bodies often occurs in the evening or at night. Preoperative (radiologic) diagnostics show a lack of sensitivity and specifity. Due to the large number of patients, endoscopic removal of foreign bodies in the ENT region is considered as a safe procedure in hospitals of maximum care.

Publication History

Publication Date:
18 April 2018 (online)