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Aural foreign bodies
A Mishra1, G K Shukla, N Bhatia
1Department of Otorhinolaryngology, KG Medical College, Lucknow.
Insights
Pediatric aural foreign bodies (FB) are common in children under five, often impacted in the external auditory canal. Prompt removal using appropriate techniques, like syringing or forceps, is crucial for managing these ear foreign bodies.
Area of Science:
- Otolaryngology
- Pediatric Emergency Medicine
Background:
- Aural foreign bodies (FB) are a frequent pediatric concern.
- Self-inflicted injuries are the primary cause in young children.
Purpose of the Study:
- To analyze the characteristics and management of pediatric aural foreign bodies.
- To evaluate the efficacy of different removal techniques and anesthetic choices.
Main Methods:
- Retrospective review of 168 pediatric cases with aural foreign bodies at KGMC Lucknow.
- Analysis of patient demographics, FB type, impaction site, and treatment outcomes.
Main Results:
- Most FBs occurred in children under 5 years (69.64%) and within 24 hours (91.66%).
- External auditory canal (EAC) was the most common impaction site (86.30%).
- Non-vegetative inanimate FBs predominated (43.45%); TM perforation was rare (6.54%).
Conclusions:
- Prompt and appropriate management of pediatric ear foreign bodies is essential.
- Specific techniques like syringing, forceps, or surgical intervention are indicated based on FB characteristics.
- Dissociative anesthesia (ketamine) may be preferable to general anesthesia.
Abstract:
At KGMC Lucknow, 168 pediatric cases with aural foreign bodies (FB) were reviewed. Most of the FB were self-inflicted and seen in children under 5 years of age (69.64%), within 24 hours (91.66%) of impaction. 86.30% of FB were seen to impact in external auditory canal (EAC) and their nature revealed predominance of nonvegetative inanimate FBs (43.45%). The TM perforation was encountered in only 6.54% of cases. If the FB is a living insect, it should be drowned before being manipulated. Syringing is the method of choice for a nonimpacted relatively small FB, even if it is vegetative. It is to be avoided in the 'potential' cases of external otitis or in cases with severely impacted wax. For a tightly wedged smooth rounded FB the hook and forceps are preferred in superficially and deep lying FBs respectively. A dissociate anaesthesia (ketamine) appears to be a better choice than general anaesthesia. An end-aural incision should be preferred over post-aural one and canalplasty for access of FB should be carried out wherever necessary. The presence of otorrhoea in cases of penetrating FB or aural myasis should be dealt on the lines of otitis media after removing the FB concerned.