Ingested foreign bodies: patient-guided localization is a useful clinical tool

Area of Science:

• Otolaryngology
• Gastroenterology
• Emergency Medicine

Background:

• Ingested foreign bodies are common in Ear, Nose, and Throat (ENT) emergencies.
• Accurate localization of foreign bodies is crucial for effective removal.
• Patient-reported localization can guide diagnostic and therapeutic interventions.

Purpose of the Study:

• To compare patient-reported localization of ingested foreign bodies with their actual removal site.
• To determine if object height influences localization accuracy.
• To assess the clinical utility of patient localization in ENT foreign body management.

Main Methods:

• Prospective study of 60 patients with ingested foreign bodies presenting to ENT departments.
• Comparison of patient's perceived foreign body location with the confirmed site at removal.
• Statistical analysis of localization accuracy based on object height and anatomical location (above/below cricopharyngeus).

Main Results:

• Foreign body localization accuracy improved with increasing object height.
• Objects impacted below the cricopharyngeus muscle were poorly localized (P < 0.0001) and lateralized (P < 0.0001).
• Patient ability to lateralize a foreign body suggests it is likely above the cricopharyngeus and visible on indirect laryngoscopy.

Conclusions:

• Patient localization of ingested foreign bodies is a valuable clinical indicator, particularly for objects in the upper cervical region.
• Objects below the cricopharyngeus are challenging to localize, potentially due to differences in pharyngeal and esophageal innervation.
• Accurate patient localization can predict foreign body visibility and suitability for bedside removal in emergency departments.