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External Auditory Canal Foreign Body Extraction Outcomes
Kaveh Karimnejad1, Erik J Nelson2, Rebecca L Rohde3
11 Department of Otolaryngology-Head and Neck Surgery, Saint Louis University School of Medicine, St. Louis Missouri, USA.
Insights
Pediatric external auditory canal (EAC) foreign body removal is more successful in otolaryngology clinics than emergency departments. Spherical objects and multiple removal attempts decrease success rates.
Area of Science:
- Otolaryngology
- Pediatric Emergency Medicine
- Medical Device Technology
Background:
- Foreign bodies in the pediatric external auditory canal (EAC) are common presentations.
- Management strategies vary based on clinical setting, impacting outcomes.
Purpose of the Study:
- To compare the success rates of pediatric EAC foreign body extraction between emergency departments (ED) and otolaryngology (OTO) clinics.
- To identify factors influencing successful foreign body removal in children.
Main Methods:
- Retrospective chart review of 1197 pediatric patients with EAC foreign bodies from January 2010 to April 2015.
- Analysis of patient demographics, foreign body characteristics, removal techniques, and complications.
- Comparison of outcomes based on clinical setting (ED vs. OTO).
Main Results:
- Successful removal rates were significantly higher in the OTO clinic (92.9%) compared to the ED (67.9%).
- Beads and spherical objects were associated with lower success rates.
- Complication rates were substantially higher in the ED (35.7%) versus the OTO clinic (5.0%).
Conclusions:
- The ED is a common initial point of care for pediatric EAC foreign bodies, but with lower success rates and higher complication risks.
- Referral to an otolaryngologist is recommended for spherical foreign bodies or after an initial unsuccessful removal attempt.
Objectives:
To compare pediatric external auditory canal (EAC) foreign body extraction outcomes by clinical setting and identify factors predictive of successful removal.
Methods:
Retrospective review of pediatric patients with EAC foreign bodies to a single institution emergency department (ED) and otolaryngology clinic (OTO) between January 2010 and April 2015. Patient characteristics, foreign body type, removal attempts, instrumentation utilized, and complications were evaluated with respect to clinical setting and patient outcome.
Results:
In all, 1197 patients with EAC foreign bodies were identified, 759 (63%) of whom presented primarily to the ED. Successful removal was achieved in OTO in 92.9% of cases and the ED in 67.9% of cases. Beads and spherical objects had the overall lowest rates of successful removal. Likelihood of removal decreased significantly after one unsuccessful attempt. Complications were reported in 35.7% of patients undergoing removal in the ED and 5.0% of patients undergoing removal in the otolaryngology clinic.
Conclusions:
Patients commonly present to the ED for removal of EAC foreign bodies. Referral to an otolaryngologist is recommended if the object is spherical or after one unsuccessful attempt at removal.
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