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Clinical features and management of aspiration of plastic pen caps
Min Chen1, Jie Zhang, Weiyi Liu
1ENT Department, Beijing Children's Hospital, Capital Medical University, Beijing 100045, PR China.
Insights
Pen cap aspiration is uncommon in children but frequently occurs in school-aged individuals. Rigid bronchoscopy with specialized forceps is the preferred removal method, though surgical options remain.
Area of Science:
- Pediatric Otolaryngology
- Respiratory Medicine
Background:
- Pen cap aspiration is an infrequent yet significant cause of pediatric airway foreign body obstruction.
- School-aged children are particularly susceptible to this type of foreign body inhalation.
Purpose of the Study:
- To delineate the clinical characteristics associated with pen cap aspiration in children.
- To evaluate the efficacy and safety of various pen cap removal techniques.
Main Methods:
- A retrospective review of pediatric patients with pen cap airway foreign bodies treated at Beijing Children's Hospital from 2006 to 2010.
- Analysis of clinical data, including patient demographics, physical examination findings, radiological results, and treatment outcomes.
Main Results:
- Forty-four children were analyzed, with a median age of 8.7 years and a male predominance (7.8:1).
- Most cases (75%) were diagnosed within one week of inhalation.
- Rigid bronchoscopy under general anesthesia was successful in 89% of cases, with reverse grasping forceps proving more effective than ordinary forceps (62% vs. 38%).
Conclusions:
- Pen cap aspiration is a notable airway foreign body issue in school-aged children.
- Rigid bronchoscopy utilizing general anesthesia and reverse grasping forceps is the optimal extraction method.
- Contingency plans for open surgical intervention (tracheotomy, thoracotomy) are essential for complex cases.
Objective:
To describe the clinical features of pen cap aspiration and removal techniques.
Study Design:
We retrospectively reviewed all children with a history of inhaling a pen cap who were referred to the ENT department, at Beijing Children's Hospital, between Jan 2006 and Dec 2010. Methods Clinical data was recorded, including patients' common information, physical examination, radiologic data and final outcome.
Results:
Data from 44 children, with a median age of 8.7 years of age (35 months to 12 years) and a male-female ratio of 7.8:1 were analyzed. The time between inhalation and diagnosis with extraction of the foreign body ranged from several hours to 6 years, but 75% (33/44) were seen within one week. 89% (39/44) had pen caps removed by rigid bronchoscopy under general anesthesia. Reverse grasping forceps were used in 62% of the cases and ordinary forceps in 38% of the cases (24/15, p<0.05). In 2 cases, the pen caps were coughed up. In 2 cases the FB was removed via a tracheotomy and in 1 case by thoracotomy.
Conclusions:
Pen caps are an unusual foreign body in the airway, occurring frequently in school age children. Rigid bronchoscopy under general anesthesia with reverse grasping forceps was the most favorable method for extraction of pen caps, but open surgical approaches should be available.
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