Foreign Bodies In Ear Research Articles

Ear Foreign Body in Paediatric Patients: Methods of Removal and When to Refer.

Paediatric patient with a foreign body in the ear may be present primarily to primary care physician or being referred to the otorhinolaryngology (ORL) clinic. The foreign bodies vary from organic to inorganic material with different sizes and shapes. Removal of foreign body in the ear canal requires adequate clinical experience as well as proper clinical instruments and cooperative clinical staff. Throughout the years, many clinical instruments and devices have been designed and proven to able to facilitate a smooth procedure with high success rates. However, an agitated child may be uncooperative and the increase in the number of attempts will result in injury of the ear canal or displacement of foreign body to the middle ear. Thus, clinical experience is essential and the doubtful cases are preferably to be performed under general anaesthesia to prevent complications.
 Bangladesh Journal of Medical Science Vol.18(2) 2019 p.423-426

Pediatric ear foreign body retrieval: A comparison across specialties.

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. 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. 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. 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.

Management of Otological Foreign Bodies Impaction in Tertiary Health Care Center

Background: Otologic foreign body impaction are common ear disorder with an associated challenge due to high levels with of pre-hospital unskilled attempted removal.
 Aim: This study aimed at determining the prevalence, socio-demographic features, etiology, clinical presentation, management and outcome in a tertiary health care center in Nigeria.
 Materials and Methods: This is a prospective hospital-based study of all patients with an impacted otologic foreign body. Consented patients were studied between October 2015 and September 2017. The interviewer-assisted questionnaire was used to collect data. Analysis of obtained data was done SPSS version 16.0.
 Results: Prevalence of otologic foreign body impaction was 4.5%. There were 58.5% males with a male to female ratio of 1.5:1.
 The main type of ear foreign body impaction was 85.2% organic (living or dead) and 14.8% inorganic. Commonest otologic foreign body were a cotton bud, insects and seeds in 38.5%, 17.0% and 11.9% respectively.
 The foreign body was unilateral in 97.0% and bilateral in 3.0%. Left ear in 42.2% and right ear in 54.8%. The foreign body was in the external canal in 97.8% and middle ear cleft in 2.2%.
 Main sources of referral were self-reporting in 30.4% and general practitioners in 22.2%.
 Commonest predisposing factors were 31.1% allergy, 23.7% otitis externa, 15.6% earwax and 3.0% mental disorders.
 Conclusion: There are the different type of otology foreign body in all age group and associated predisposing factors. Pre-hospital attempt removal by unskilled sympathizers and untrained health workers leads to avoidable complications.

Aural and nasal foreign bodies in children – Epidemiology and correlation with hyperkinetic disorders, developmental disorders and congenital malformations

ObjectivesForeign body incorporation in children is often a serious situation. Attention deficit hyperactivity disorder (ADHD) could be a risk factor for self-insertion of foreign bodies. Large cohort analyses are missing. MethodsThis was a retrospective analysis of patients’ records from a health insurance company representing 2.19% of the German population and 1.75% of German children and adolescents. According to the International Classification of Diseases, children in the age range between 1 and 18 years have been screened for foreign bodies in ear, nasal sinus and nostrils as well as for hyperkinetic disorders (F90), disorders of psychological development (F80–F89), and congenital malformations, deformations and chromosomal abnormalities (Q00–Q99). ResultsIn total, 12887 children (6609 male; 6278 female) have been treated in 16929 cases. The majority (n = 10041 (77.9%)) presented with foreign body incorporation on a single occasion. On average, 1.31 cases of foreign body treatment were recorded per child; 14.1% of children with foreign body treatment (FBT) also had a record of hyperkinetic disorder, 52.7% had a disorder of psychological development, and 50.8% a congenital malformation. Mean occurrence of FBT was 174.8 days before the diagnosis of a hyperkinetic disorder but 517.2 days after the diagnosis of a psychological development disorder and 683.1 days after the diagnosis of a congenital malformation, deformation or chromosomal abnormality. ConclusionPatients with disorders of psychological development as well as children with congenital malformations are high-risk patients for nasal and aural foreign bodies. The prevalence of a hyperkinetic disorder in patients with FBT is much higher than in the normal population. ADHD is a risk factor for foreign bodies.

Otolaryngological foreign bodies in a tertiary medical center in Turkey: A comparison of pediatric and adult patients

Aim: The aim of the present research was to report on the characteristics of ear, nose, and throat foreign bodies in patients admitted to a tertiary medical center in Turkey and to analyze the extraction procedure, results, and complications. Material and Methods: A retrospective study conducted between August 2015 and May 2019 included 1042 patients referred to the emergency and otolaryngology department with ear, nose, and throat foreign bodies. The pediatric group included 612 cases, while the adult group included 430 cases. Sex, the type of foreign bodies, symptoms, extraction method, and complications were analyzed. Results: The most common foreign bodies were hard round objects frequently found in front of the middle turbine in the nose of children, while pieces of cotton buds were found in the outer ear canal in adults. In the pediatric group, the distribution of foreign bodies was 53.43% in boys and 46.57% in girls. Furthermore, the intervention was performed in three children (0.49%) admitted to the emergency department because of the organic foreign body escaping to the throat, as a result of which foreign bodies were removed. However, the prognosis for these patients was poor: a neurological sequela in one patient, death in two patients. In the adult group, the distribution of foreign bodies was 49.76% in males and 50.24% in females. No fatal cases were observed in this group. The ratio of foreign bodies removed under general anesthesia in the pediatric group was 3.43%, while it was 0.23% in the adult group, and the difference between them was statistically significant (p = 0.018). No statistical difference was observed between the groups with regard to complication rates (p>0.05). Conclusion: Otolaryngological foreign bodies are usually harmless, but they can cause infections and minor complications when they are overlooked or there is prolonged exposure, and these objects in the throat may be fatal, especially in children.

Cost comparison and safety of emergency department conscious sedation for the removal of ear foreign bodies

ObjectivesThe purpose of this study is to investigate the relative cost and safety of ear foreign body (FB) removal via conscious sedation in the emergency department. MethodsA retrospective review of patients presenting from 2000 to 2015 to the emergency department at Mayo Clinic, Rochester, Minnesota was performed. 63 patients requiring sedation for ear foreign body removal were identified. Descriptive data, safety data, and costs were obtained for the study. ResultsThere were no appreciable differences in patient safety outcomes and otologic outcomes in patients who received sedation in the emergency department or anesthesia in the operating room for FB removal. Cost analysis demonstrated increased cost associated with operating room utilization verses conscious sedation in the emergency department, with the greatest cost increase being in patients evaluated first in the emergency department and then sent to the operating room. ConclusionsEar foreign body removal in the emergency department is shows a similar safety profile to removal in the operating room, but at a markedly lower cost. Emergency department conscious sedation should be considered a viable option in appropriately selected patients with this common problem given these results.

Analysis of ear foreign bodies in adult patients

Background: Foreign bodies (FBs) in the ear are frequently encountered by an otolaryngologist. Certain types of ear FBs in our adult patients may reflect negative phenomena in our community. Objectives: This study was carried out to analyze the main types of adult aural FBs and to highlight the increasing frequency of already known types and more interesting newly known type of FB. Materials and Methods: This is a prospective descriptive study of adult patients with aural FB seen in the ENT Department in Al-Mahawil Hospital for the 2 years – 2015 and 2016. The clinical presentation, type of FB, and management outcome were analyzed. Results: Two hundred and thirty-two patients aged 18–82 years were evaluated. Cotton wool (of the earbuds) was the most common FB with 93 (40%) patients (male: 54, female: 39) aged 21–82 years; the insect FB with 78 (33.7%) patients (male: 32, female: 46) aged 18–58 years; and garlic with 36 (15.5%) patients (male: 15, female: 21) aged 25–74 years; the newly known interesting FB put by the students into their ears during the examination was Bluetooth device in 15 (6.5%) patients (male only) aged 18–23 years; and miscellaneous FBs such as paper, broken matchstick and clinics were found in 10 (4.3%) patients (male: 7, female: 3) aged 35–60 years. All the FBs were unilateral and removed successfully without anesthesia, except four cases removed under general anesthesia. Complications did occur such as otitis externa: 8, bleeding and laceration: 6, and abrasion: 10. The complications were mainly due to previous unsuccessful trials and delayed referral. Conclusion: The increased abuse of earbuds causes more incidence of FB in the ears. We have seen more garlic in the ears because of misunderstanding of some traditional thoughts. Moreover, recently, we observed new FB, Bluetooth device objects in the ears of students. Health education of the general population is necessary for prevention.

Ear Foreign Body: A Study of 148 Cases

Ear foreign body is a common ENT emergency and a challenge also to otolaryngologist worldwide. Prompt and appropriate management of it can reduce the morbidity. An observational retrospective study of 148 cases of foreign body in the ear done in Comilla Medical College Hospital and two upazilla health complexes (Nangalkot and Chowddagram) of Bangladesh within the period of January 2014 to December 2014 to evaluate the nature, mode of presentation, technique of removal and outcome of it. Data were collected from hospital records including age, sex of patient and mode and time of presentation, nature of foreign body, management outcome and complication, and the result showed that children o funder 15 year age group were mostly affected (60%), among them highest incidence were in 5-10 year age group (25%) with male to female ratio 1:1.28. The most common foreign body was the seeds of various vegetables (25.67%) followed by plastic beads (18.24%) and cotton bud (15.54%), the right ear affected more (54%). Almost half of them (47.97%) presented with history of insertion of a foreign body and most of them (91.98%) were removed in OPD or emergency department under direct vision and remaining required general anesthesia. Despite a high proportion of cases managed in the office setting, complication rates were within acceptable level. It is inversely proportional to the skill of the personnel, number of attempts &availability of equipment. Key to successful outcome are prompt help by well-trained doctor and otolaryngological equipment set up.Medicine Today 2017 Vol.29(2): 5-8

Pattern of Otalgia in Ekiti, Nigeria

Background: Otalgia is a discomforting otological symptom. The cause may be within or outside the ear. This study aimed at determining the clinico-epidemiological patterns, quality of life, type and aetiology of otalgia. Materials and Methods: It is a prospective hospital based study of patients with complaints of earache. The study was carried out in the ear, nose and throat department of Ekiti state university teaching hospital, Ado Ekiti over a period of one year, from May 2016 to April 2017. Data were obtained by using pretested interview assisted questionnaires from subjects that gave consent. Data obtained were collated, documented and analyzed by using SPSS version 16.0. Ethical clearance was sought for this study from the ethical committee of the institution. Results: Out of a total of 2,616 patients seen, 947 patients presented with complaints of earache. The prevalence of otalgia was 36.2%. There were 31.3% children (1-18 years) and 68.7% adults. The peaked age of otalgia occured at third decade (21-30 years), with a prevalence of 27.7%. There were 621(65.6%) males and 326 (34.4%) females with a male to female ratio of 2:1. Majority (89.1%) of the studied patients were Christian. About 26.6% of our patients were students/apprentice. Majority of the patients were referred to the department by general practitioners in 40.8% of the patients. In this study, main accompanied symptoms were otorrhea, hearing impairment, itching, ear fullness and feeling of movement in ear and these were 29.7%, 23.7%, 23.0%, 20.9% and 18.7% respectively. Other symptoms were toothache, sore throat, cough and hoarseness and these were 6.7%, 6.1%, 4.3% and 3.1% respectively. In this study, majority of the otalgia were secondary to 25.4% otitis externa, 13.6% impacted earwax, 11.9% otitis media and 7.7% tonsillitis. Otogenic otalgia accounted for 67.4% while referred otalgia accounted for 32.6%. Unilateral otalgia accounted for 80.6% while bilateral otalgia accounted for 19.4%. Right otalgia accounted for 47.4% and left otalgia accounted for 33.2% of the studied patients. Majority (65.7%) of the studied patients had noticed sleep disorder. Findings in this study revealed minority of the patients had 36.9% medical treatment while majority had 63.1% surgical treatment inform of ear lavage, aural toilet, aural dressing and foreign body removal. Prior to presentation in ENT department almost half (49.8%) of the patients had over the counter medication and 24.6% herbal treatment, 17.8% had prescribed medication while 7.7% had no treatment. Conclusions: Otalgia has high prevalence among complaints in otorhinolaryngological practice. The prevalence of otalgia was recorded in 36.2% of patients in this study. Majority of the patients presented to non specialist with otogenic and non otogenic aetiology effecting quality of life of sufferer.

Types of Foreign Body In Ear, Nose And Throat In Western Part of Nepal

Types of Foreign Body In Ear, Nose And Throat In Western Part of Nepal

A Portrayal of Childhood Injury among Under-Five Year Children

Introduction:Children and injuries are always closely associated. Injuries to children irrespective of its seriousness will affect the whole family function. One of the major reasons for childhood morbidity and mortality are injuries. Method: A cross sectional house to house survey was conducted in Udupi Taluk to identify the major types of childhood injuries. The study also tried to find the association between the age of the child and the common injuries.Results:The present study used a sample subject of 2040 for the survey. The mean age of children included in the study were 2.60 (SD + 1.16) years. Majority of children included in the survey were males 52.5%. The overall injury identified in survey was 14%. Fall from stairs (92%), burn with hot water/food (41%), injury with a sharp knife (72%), accidental ingestion of medicine (3%), injury during play (94%) and foreign body in ear and nose (79%) were identified as the most common injuries among children of 2 to 5 years.Conclusion:This article establishes the need for a detailed prevalence survey. A detailed survey will help in planning an intervention for caregivers which can reduce the injuries in children.

Ear, Nose and Throat Foreign Bodies Removed under General Anaesthesia: A Retrospective Study.

For Otorhinolaryngologist, removal of Foreign Bodies (FB) from the ear, nose and throat is one of the common emergency procedures done. Most of the cases especially of the ear and nose can be managed without General Anaesthesia (GA). But in some cases GA may be needed. There are very few studies that address the scenario of ear, nose and throat foreign body that required GA for its removal and the complications associated with it. This study was conducted with the aim to study the patient's profile, types and distribution of FB removed under GA, and the associated complications. The present study is a hospital based retrospective, cross-sectional study conducted in the Department of Otorhinolaryngology in association with Department of Anaesthesiology and Critical Care in North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India from year 2009 to 2014. Information was collected from indoor patient file and operation record book. Those patients where foreign body was not found after examination under GA were excluded. A total of 112 cases of foreign body in ear, nose and throat removed under GA were selected. There was variation of age from youngest case being 11 months to 74 years with a slight male predominance. Two third of the patients belonged to paediatric age group. Most of the FB were inanimate with high number of inorganic type found in majority. Foreign body in food passage was found in most cases. Coin and meat bone were the common FB in children and adults respectively. We found no complications related to removal of foreign body from the food passage and nose. But some complications were seen in foreign body of ear and tracheo-bronchial tree. Ear, nose and throat FB that required GA were seen in all age groups. FB of food passage constitute the majority. Type of foreign body varies between children and adults. In children most common types were related to toys and their part and food materials. In adults, food materials were most common.

A case of external and middle ear foreign body accompanied by fracture and transection of the ear ossicles caused by a hearing aid impression material

A case of external and middle ear foreign body accompanied by fracture and transection of the ear ossicles caused by a hearing aid impression material

Ear, nose, throat foreign bodies: experience in the tribal population

<p class="abstract"><strong>Background:</strong> Foreign bodies (FB) in the ears, nose or throat are a common occurrence in otorhinolaryngology (ENT) emergency services. The management calls for prompt & precise intervention which in turn decreases the overall morbidity and mortality. The aim of the study was to study the age & gender distribution, modes of presentation, management & complications of various foreign bodies in patients attending emergency & ENT OPD.</p><p class="abstract"><strong>Methods:</strong> It is a prospective, interventional clinical study conducted in a tertiary Care Hospital – Shri Vasantrao Naik government medical college situated in tribal region of Yavatmal, Maharashtra. About 200 patients from the tribal population with foreign body in ear, nose & throat region from November 2012 to October 2014 were included in the study. </p><p class="abstract"><strong>Results:</strong> Out of 200 patients, the commonest location of FB was in ear with 103 patients (51.5%) followed by nose with 72 patients (36%) and throat 25 patients (12.5%). 203 FB were removed from 200 patients. Throat cases include digestive tract (21 cases) and tracheobronchial (4 cases) FB. Amongst the FB in throat the commonest was fish bone and the commonest site being cricopharynx. Seeds were the commonest FB in ear & nose. A greater proportion of cases - 109 (54.5%) were below 10 years of age.</p><strong>Conclusions:</strong> A great degree of suspicion, prompt diagnosis and timely intervention can reduce the overall mortality and morbidity associated with ear, nose and throat foreign bodies.

Removal of superglue from the external ear using acetone: a case report

Foreign bodies in ear are a common occurrence and are commonly seen in the practice. But some foreign bodies require special attention. We here describe a unique situation of cynoacrylate glue or superglue in the external auditory canal which was removed using acetone solution. Acetone solution instilled in the ear canal enabled complete removal of the glue while preserving the anatomy of the ear canal and tympanic membrane.

A retrospective investigation of clinical profile and management of foreign bodies in ear

A retrospective investigation of clinical profile and management of foreign bodies in ear

Migrated aural foreign body in parapharyngeal space

Foreign bodies in ear are very frequently encountered by an otorhinolaryngologist. They should be diagnosed and removed immediately. Otherwise it may cause complications like tympanic membrane perforation, chondritis, ossicular necrosis, facial palsy, inner ear injury or it may migrate to adjacent structures. It may migrate to subcutaneous tissue or middle ear. Migration of aural foreign body to parapharyngeal space is very rare and never been reported in literature. We are reporting this type of very unusual migrated foreign body which was recovered from the parapharyngeal space by a small incision endoscopic assisted approach after 8 years if insertion.

English

English

Socio-demographic Study of Foreign Bodies of Ear, Nose and Throat of Children in Western Uttar Pradesh

Socio-demographic Study of Foreign Bodies of Ear, Nose and Throat of Children in Western Uttar Pradesh

Foreign Body in Middle Ear: Our Experience

Background: Individuals often come to hospital with cases of foreign body ear. Foreign body middle ear though rare can lead to complications if not removed early in the course. Objective: This study was done to analyse the patients with foreign body ear, the common causes which lead to foreign body middle ear and its management. Material and Method: A review of cases of foreign body ear over two years was done from May 2013 to June 2015 and cases with foreign bodies embedded in middle ear were documented and their cause and management was tabulated. Results: Total of 30 patients were screened with 20 males & 10 females mean age group being 7 years. 26 patients had iatrogenic perforation of tympanic membrane by inexperienced hands that lead to middle ear foreign body. Management of 90% of the cases was done under operating microscopic examination permeatally under general anaesthesia and in few cases post aural approach was used. Conclusion: Foreign bodies in middle ear are most commonly a reason of wrong handling of patients by inexperienced hands and can lead to permanent disability.