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Foreign Bodies in ORL Area in Children


Authors: A. Fryčková;  K. Sobotková;  K. Kolejková;  P. Marková;  G. Forstová
Authors‘ workplace: Klinika dětské ORL LF MU a FN, Brno přednosta prof. MUDr. I. Šlapák, CSc.
Published in: Otorinolaryngol Foniatr, 58, 2009, No. 2, pp. 71-78.
Category: Original Article

Overview

Foreign bodies (FB) in ORL are usually encountered in children only. Under general anesthesia (GA) FB should be removed in non-collaborating children or in cases of wedged FB in external auditory duct or nasal cavity as well as all foreign bodies from lower respiratory pathways or esophagus.

Foreign bodies get into the ear mostly accidentally, mainly during ear sanitation. Our retrospective study of the period of 2000 to 2006 has paid attention to 308 patients examined for suspected foreign body in the ear. These were 107 girls and 201 boys on the mean age of 7.5 year. A foreign body was found in 279 cases. Inorganic foreign bodies were most frequent. In 12 cases the foreign body had to be removed under GA.

Nasal foreign bodies occur also in younger children, most often at the preschool age. In the period of observation, 674 patients have been examined on the whole and a foreign body was found and subsequently extracted in 528 patients. These were 246 boys and 282 girls at the mean age of 3 years. The FB extraction was performed in outpatients in most cases, only in 14 cases hospitalization proved to be necessary and the extraction was performed under general anesthesia. Again, inorganic foreign bodies are the most frequent ones.

The aspiration of a foreign body represents a life-threatening condition requiring immediate surgical intervention. In the period of observation 158 patients have been treated for suspected foreign body, bronchoscopy in general anesthesia was made in 129 cases and foreign body was found and subsequently extracted in 60 patients From this total there were 68 girls and 88 boys at the mean age of 3.3 year.

Foreign bodies in the swallowing pathways are those which are lodged or wedged in oral cavity, pharynx, esophagus or stomach. Foreign bodies in the swallowing pathway cause the feeling of pressure, pain in the GIT region, irritation to vomiting, impossible swallowing, excessive salivation, rasping, and short-windedness and in cases of possible madiastinitis also subcutaneous emphysema. It the period of observation we have examined a total of 546 patients with suspected FB in the swallowing pathways. In the out-patient department 341 patients suspected for FB in the area of oral cavity, pharynx and hypopharynx have been examined. A FB was removed in 193 patients. The suspected swallowed FB was subject to examination in 205 patients – 95 boys and 110 girls – 55 of which were admitted to hospital for subsequent esophagoscopy in GA. FB was found and subsequently removed from esophagus in 32 patients.

Key words:
foreign body, ear, nasal cavity, respiratory pathways, swallowing pathways.


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