The Effect of Developmental Delay and Autism Spectrum Disorder on External Auditory Canal Foreign Body Extraction

Area of Science:

• Otolaryngology
• Pediatric Medicine
• Developmental Pediatrics

Background:

• Pediatric external auditory canal foreign body (EAC FB) retrieval outcomes can be influenced by underlying neurodevelopmental conditions.
• Developmental delay (DD) and autism spectrum disorder (ASD) are increasingly recognized as factors affecting healthcare encounters in children.

Purpose of the Study:

• To investigate the impact of DD and ASD on the outcomes of pediatric EAC FB retrieval.
• To compare presentation, management, and recurrence rates of EAC FB in children with and without DD/ASD.

Main Methods:

• Retrospective chart review of 1467 pediatric patients undergoing EAC FB removal from January 2018 to December 2019.
• Analysis of demographics, symptoms (otalgia), complications, number of episodes, and need for operating room (OR) removal.
• Stratification of patients based on the presence of DD and ASD.

Main Results:

• Children with DD and ASD were older at presentation and more likely to require OR removal (36.5%) compared to non-DD/ASD (NDD) peers (16.7%).
• Patients with DD/ASD experienced significantly more EAC FB episodes (1.6-1.8) versus NDD (1.1), with hazard ratios of 4.5 for DD and 5.6 for ASD for multiple episodes.
• DD patients reported less otalgia (26.3%) than NDD patients (37.4%), while complication rates remained low across all groups.

Conclusions:

• Physicians must maintain heightened vigilance for EAC FB in children with DD and ASD due to atypical presentations.
• A lower threshold for referral to otolaryngology specialists may improve management and outcomes for these vulnerable pediatric populations.
• Understanding the unique clinical characteristics of DD and ASD patients is crucial for effective EAC FB management.