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[Laryngeal foreign bodies: management in children in Senegal]
Insights
Foreign body inhalation in children, particularly in the larynx, is a severe issue. Tracheostomy is crucial for managing laryngeal foreign bodies and reducing mortality, even with potential complications.
Area of Science:
- Pediatric Otolaryngology
- Emergency Medicine
- Public Health
Context:
- Inhalation of foreign bodies is a common pediatric emergency.
- Laryngeal foreign bodies pose significant risks to children's health.
- This study reviews cases from Dakar University hospital over 16 years.
Purpose:
- To analyze the etiological, clinical, and therapeutic aspects of laryngeal foreign bodies in children.
- To highlight the challenges and outcomes of managing these cases.
- To evaluate the role of tracheostomy in laryngeal foreign body management.
Summary:
- A retrospective review of 145 airway foreign bodies identified 65 laryngeal cases (44.8%) in children.
- Delayed presentation (over 24 hours) was common (73.33%), with significant laryngeal dyspnea (83%).
- Tracheostomy was performed in 55.4% of cases, with a 4.16% mortality rate.
Impact:
- Laryngeal foreign bodies represent a high percentage of airway foreign body cases.
- Tracheostomy remains a vital intervention for managing laryngeal foreign bodies, reducing mortality.
- Improved public awareness and infrastructure are essential for better outcomes.
Unlabelled:
Inhalation of foreign bodies is a frequent accident in children. It remains severe in the case of laryngeal foreign bodies.
Patients And Methods:
Retrospectively, for a 16-year period, 65 laryngeal foreign bodies have been treated (44.8%), among 145 cases of airway foreign bodies, in the ENT department of Dakar University hospital. Etiological, clinical and therapeutic aspects were reviewed.
Results:
Average age was 36 months, with a sex-ratio of 2.42 in favour of males. The time lag (time between the accident and admission to the department) was particularly long; 73.33% of the children were admitted more than 24 hours after the event. Eighty-three percent of the patients presented greater or lesser laryngeal dyspnea. Tracheostomy was performed in 55.4% of the patients. Average duration for abiation of the canula was ten days. Three cases of death were recorded (4.16%).
Discussion:
The frequency of 44.8% for laryngeal localization of foreign bodies appears to be the highest in the literature. If the appropriate treatment for foreign bodies in the respiratory tract is endoscopic removal, the tracheostomy nevertheless occupies a central place in the management of the disease. This procedure may be recommended to all ENT specialists working in similar conditions. In spite of its inherent complications, tracheostomy allows reduction of mortality in relation to laryngeal foreign bodies. Improvement of prognosis requires prevention based on widespread public information and improving technical infrastructures.