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Aural and nasal foreign bodies in children - Epidemiology and correlation with hyperkinetic disorders, developmental
Tobias Schuldt1, Wilma Großmann1, Nora M Weiss1
1Department of Otorhinolaryngology, Head and Neck Surgery "Otto Koerner", Rostock University Medical Center, Rostock, Germany.
Insights
Attention deficit hyperactivity disorder (ADHD) is a significant risk factor for foreign body insertion in children. Children with developmental disorders or congenital malformations also face higher risks for nasal and ear foreign bodies.
Area of Science:
- Pediatrics
- Otolaryngology
- Child Psychology
Background:
- Foreign body incorporation in children is a frequent and serious concern.
- Attention deficit hyperactivity disorder (ADHD) is suspected as a risk factor for foreign body self-insertion.
- Large-scale cohort studies investigating this association are lacking.
Purpose of the Study:
- To investigate the association between foreign body treatment (FBT) in children and neurodevelopmental disorders.
- To determine if ADHD and other developmental conditions are risk factors for foreign bodies in children.
- To analyze a large dataset of pediatric health insurance claims.
Main Methods:
- Retrospective analysis of health insurance records for 12,887 children (ages 1-18) in Germany.
- Screening for foreign bodies in the ear, nasal sinus, and nostrils.
- Analysis of diagnoses including hyperkinetic disorders (F90), disorders of psychological development (F80-F89), and congenital malformations (Q00-Q99).
Main Results:
- 16,929 cases of foreign body treatment were recorded among 12,887 children.
- 14.1% of children with FBT had a record of hyperkinetic disorder (ADHD).
- 52.7% had disorders of psychological development, and 50.8% had congenital malformations.
Conclusions:
- Children with disorders of psychological development and congenital malformations are at high risk for nasal and aural foreign bodies.
- The prevalence of hyperkinetic disorder (ADHD) is significantly higher in children with FBT compared to the general population.
- ADHD is confirmed as a risk factor for foreign body incorporation in children.
Objectives:
Foreign body incorporation in children is often a serious situation. Attention deficit hyperactivity disorder (ADHD) could be a risk factor for self-insertion of foreign bodies. Large cohort analyses are missing.
Methods:
This was a retrospective analysis of patients' records from a health insurance company representing 2.19% of the German population and 1.75% of German children and adolescents. According to the International Classification of Diseases, children in the age range between 1 and 18 years have been screened for foreign bodies in ear, nasal sinus and nostrils as well as for hyperkinetic disorders (F90), disorders of psychological development (F80-F89), and congenital malformations, deformations and chromosomal abnormalities (Q00-Q99).
Results:
In total, 12887 children (6609 male; 6278 female) have been treated in 16929 cases. The majority (n = 10041 (77.9%)) presented with foreign body incorporation on a single occasion. On average, 1.31 cases of foreign body treatment were recorded per child; 14.1% of children with foreign body treatment (FBT) also had a record of hyperkinetic disorder, 52.7% had a disorder of psychological development, and 50.8% a congenital malformation. Mean occurrence of FBT was 174.8 days before the diagnosis of a hyperkinetic disorder but 517.2 days after the diagnosis of a psychological development disorder and 683.1 days after the diagnosis of a congenital malformation, deformation or chromosomal abnormality.
Conclusion:
Patients with disorders of psychological development as well as children with congenital malformations are high-risk patients for nasal and aural foreign bodies. The prevalence of a hyperkinetic disorder in patients with FBT is much higher than in the normal population. ADHD is a risk factor for foreign bodies.
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