Pediatric ear foreign body retrieval: A comparison across specialties
Autor: | Kyra Osborne, Katie Mingo, David J. Eleff, Samantha Anne |
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Rok vydání: | 2020 |
Předmět: |
medicine.medical_specialty
Adolescent Referral Sedation 03 medical and health sciences 0302 clinical medicine Otolaryngologists otorhinolaryngologic diseases medicine Humans Child 030223 otorhinolaryngology Retrospective Studies Tympanic Membrane Perforation business.industry Age Factors Infant Ear Emergency department Foreign Bodies medicine.disease Foreign Body Removal Surgery Otorhinolaryngology Child Preschool 030220 oncology & carcinogenesis Foreign body Presentation (obstetrics) medicine.symptom business |
Zdroj: | American Journal of Otolaryngology. 41:102167 |
ISSN: | 0196-0709 |
Popis: | Objectives To analyze what characteristics of patients and/or ear foreign bodies should prompt referral to otolaryngology with the goal to maximize successful removal and minimize complications. Methods This was a retrospective chart review of pediatric patients who presented for ear foreign body removal from January to December 2016 at a tertiary hospital center. Data collection included successful removal, major or minor complications, use of general or conscious sedation, use of otic or oral antibiotics, age of patient, comorbid behavioral disorders, and foreign body characteristics. Major complications included tympanic membrane perforation or ossicular damage. Minor complications included injury of the canal wall. Patients with retained or extruded tympanostomy tubes were excluded. Results Of 275 patients aged 1–18 years, 16% presented initially to otolaryngology (ENT), 48.4% presented to the emergency department (ED), 21.8% presented to a pediatrician, and 13.8% presented to ENT after prior attempts at removal. Rate of successful retrieval by ENT was significantly higher than by PCP (95.4% vs 75.0%) or by ENT after prior failed attempts (65.8%), but not when compared to removal in the ED (85.7%). Retrieval by ENT after prior failed attempts had the highest rate of minor complications (26.3% vs 2.3–6.0%). There were two tympanic membrane perforations that were noted by ENT after prior failed attempts. Rate of operative intervention was significantly higher in patients who presented to ENT after prior attempts compared to patients who presented initially to ENT (34.2 vs 4.6%, p = 0.001). Of the patients who presented to ENT after previous failed attempts, there was a higher rate of complications and operative intervention if the patient was age 5 or under or the foreign body was difficult to grasp. Conclusions Pediatric ear foreign body presentation is common. Repeated attempts at removal are associated with higher rates of minor complications and operative intervention. Early consultation to otolaryngology should be considered if the foreign body is deemed difficult to grasp such as a bead or stone, especially if the patient is age five or younger. |
Databáze: | OpenAIRE |
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