Learning Curve of Upper Aerodigestive Tract Foreign Body Management for Otorhinolaryngology Residents

ORL ◽  
2021 ◽  
pp. 1-7
Author(s):  
Ching-Ching Chiu ◽  
Chien-Yu Huang ◽  
Keng-Ming Chang ◽  
Sheng-Chiao Lin ◽  
Yu-Hsi Liu ◽  
...  
Keyword(s):  
Emergency Department ◽  
Foreign Body ◽  
Learning Curve ◽  
Foreign Bodies ◽  
Aerodigestive Tract ◽  
Deep Neck Infection ◽  
Upper Aerodigestive Tract ◽  
Negative Finding ◽  
Neck Infection

<b><i>Introduction:</i></b> Foreign body ingestion is the most common reason for otolaryngology specialist consultations in emergency departments. Among the different types of foreign bodies, fish bones are the most common, particularly in Asian populations. In Taiwan, upper aerodigestive tract foreign bodies (UADT-FBs) are mostly managed by residents in the otorhinolaryngology (ORL) department. Considering the learning curve required for all procedures, different management types between residents, and possible resulting safety issues, this study explored the outcomes of UADT-FB management by residents in different years of ORL training. <b><i>Materials and Methods:</i></b> The medical records of 2,283 patients who visited Kaohsiung Veterans General Hospital’s Emergency Department for UADT-FB during June 2013–August 2019 were retrospectively reviewed. The reviewed data included the demographic data of enrolled patients, outcomes of foreign body management, and follow-up chart records of the patients. <b><i>Results:</i></b> Among the 2,283 patients, 1,324 (58%) were found to be negative for foreign bodies, and foreign bodies in 951 (41.7%) were removed immediately. In the negative finding (NF) group, 2 (4.9%) patients were later found to be positive for foreign bodies during follow-up in the outpatient department. One (2.4%) patient developed a deep neck infection and esophageal perforation. The percentage of NFs decreased from 62.58% in residents in the first half of their first year (R1a) to 54% for third-year residents (R3). Comparing R1a with R3, the number needed to harm for retained UADT-FBs after patients visited the emergency department was 12.2. <b><i>Discussion/Conclusion:</i></b> This study provides data from 1 referral center regarding the management of UADT-FBs. With increasing resident training, the percentage of NFs declined from 62.58 to 54%. Young residents, especially those in the first 6 months of their training, should have senior residents perform a second examination if UADT-FBs are not found in suspected cases.

scholarly journals Impacted inter-arytenoid chicken bone

2020 ◽  
Vol 6 (10) ◽  
pp. 1894
Author(s):  
Manish Munjal ◽  
Shikha Gupta ◽  
Tanvir Singh ◽  
Porshia Rishi ◽  
Harjnder Sidhu ◽  
...  
Keyword(s):  
Foreign Body ◽  
Hospital Admission ◽  
Foreign Bodies ◽  
Aerodigestive Tract ◽  
Upper Aerodigestive Tract ◽  
Chicken Bone ◽  
The Common

<p>The anebriated individual with sluggish reflexes is likely to aspirate inadverently fluids, semisolids and solids alike. Fish and chicken preparations with their sharp skeletal bones may lacerate or get entangled in the mucosa of the upper aerodigestive tract. The tonsillar fauces, pyriform fossae, post cricoid region, supraglottis, glottis, subglottis, trachea, carina and either bronchi are the common sites of impaction of sharp-edged foreign bodies. We herein present a case involving a 40-year-old patient who had aspirated a laryngotracheal foreign body (chicken bone) 3 days prior to hospital admission, which was removed by tracheostomy and suspension microlaryngoscopy.  </p>

scholarly journals Wire bristle foreign body: Never in the same place twice

2019 ◽  
Vol 7 ◽  
pp. 2050313X1985344
Author(s):  
Andrew DP Prince ◽  
Ashley M Bauer ◽  
Yanjun Xie ◽  
Mark EP Prince
Keyword(s):  
Foreign Body ◽  
Emergency Room ◽  
Computerized Tomography ◽  
Foreign Bodies ◽  
Aerodigestive Tract ◽  
Common Reason ◽  
Foreign Body Ingestion ◽  
Upper Aerodigestive Tract ◽  
Close Proximity

Foreign body ingestion is a common reason for visiting the emergency room. Foreign bodies can lodge anywhere in the upper aerodigestive tract and can sometimes be difficult to extract. Wire bristles that dislodge from grill-cleaning wire brushes and which are then accidentally swallowed can be particularly challenging to remove due to their small size, propensity to become embedded, and their ability to migrate through tissues. This case reveals the speed with which wire bristle foreign bodies can migrate through tissues and exemplifies the need to obtain computerized tomography evaluations in close proximity to any planned attempt to remove them.

Foreign body in the tongue: an unusual site for a common problem

1991 ◽  
Vol 105 (10) ◽  
pp. 849-850 ◽  
Author(s):  
Kalpesh S. Patel
Keyword(s):  
Case Report ◽  
Foreign Body ◽  
Foreign Bodies ◽  
Fish Bone ◽  
Aerodigestive Tract ◽  
Upper Aerodigestive Tract ◽  
Unusual Site ◽  
Rare Site ◽  
Frequent Problem

AbstractForeign bodies in the upper aerodigestive tract represent one of the commonest ENT emergencies. A case report of a fish bone penetrating the anterior tongue is presented which exemplifies this frequent problem. but at a rare site.

Unusual complication of ingestion of a foreign body

2003 ◽  
Vol 117 (7) ◽  
pp. 566-567 ◽  
Author(s):  
J. C. Passey ◽  
Ravi Meher ◽  
Sunil Agarwal ◽  
Bulbul Gupta
Keyword(s):  
Foreign Body ◽  
Carotid Artery ◽  
Common Carotid Artery ◽  
Foreign Bodies ◽  
Interesting Case ◽  
Aerodigestive Tract ◽  
Unusual Complication ◽  
Upper Aerodigestive Tract ◽  
Common Problems ◽  
Safety Pin

Foreign bodies of the upper aerodigestive tract are common problems dealt with by the otolaryngologist. Among all foreign bodies in the oesophagus, an open safety pin still presents a challenge for the ENT specialists because of its propensity to pierce the oesophagus and surrounding structures. We present an interesting case of a long-standing foreign body i.e. an open safety pin, which, after piercing the hypopharynx, caused fatal common carotid artery rupture.

scholarly journals A retrospective review of complicated foreign bodies of upper aerodigestive tract

2019 ◽  
Vol 5 (3) ◽  
pp. 734
Author(s):  
Ritesh Mahajan ◽  
Prashanth V.
Keyword(s):  
Foreign Body ◽  
Foreign Bodies ◽  
Removal Rate ◽  
Neck Surgery ◽  
Aerodigestive Tract ◽  
Upper Aerodigestive Tract ◽  
Diagnostic Challenge ◽  
Early Management ◽  
Female Ratio ◽  
Medical College

<p class="abstract"><strong>Background:</strong> Inhalation/aspiration of foreign bodies (FB) into upper aerodigestive tract are very commonly encountered by otorhinolaryngologists. Most foreign bodies in adults are manageable, but sometimes can lead to fatal consequences in children. However, despite significant advances in instrumentation, they remain a therapeutic and diagnostic challenge. The aim was to study the clinical presentation, site of impaction, complications and management of foreign bodies in upper aerodigestive tract.</p><p class="abstract"><strong>Methods:</strong> A retrospective study was conducted in department of ENT-Head and Neck Surgery, Rajarajeswari Medical College and Hospital, Bangalore. A total of 50 eligible patients were reviewed who got operated for foreign body in upper aerodigestive tract under general anaesthesia.  </p><p class="abstract"><strong>Results:</strong> History of foreign body was present in 86% of cases and 25% of the patients had complaints of difficulty in breathing. Nose being most common site in 74%, 70% of the patient belongs to 0-10 age group and male: female ratio was 1.7:1. Complications were seen in 12% of patients. Foreign body removal rate was 100%.</p><p class="abstract"><strong>Conclusions:</strong> Early diagnosis is the key to successful and uncomplicated management of FB in upper aerodigestive tract. An orderly and systematic approach along with proper history and clinical examination is keystone in diagnosis and early management.</p>

scholarly journals Rare foreign bodies of upper aerodigestive tract: a study of 30 cases

2020 ◽  
Vol 6 (7) ◽  
pp. 1307
Author(s):  
Vivek Samor ◽  
Deepchand Sarowa ◽  
Pooja D. Nayak ◽  
Vaibhav Saini ◽  
Gagandeep Kaur ◽  
...  
Keyword(s):  
Foreign Body ◽  
Foreign Bodies ◽  
Clinical Presentation ◽  
Aerodigestive Tract ◽  
Upper Aerodigestive Tract ◽  
Common Procedure ◽  
Female Ratio ◽  
Mortality And Morbidity ◽  
High Degree ◽  
Male To Female

<p class="abstract"><strong>Background:</strong> Aero-digestive foreign bodies are prevalent in our part of the country. Apart from the usual foreign body we encountered some unique foreign bodies, the diagnosis and management of which, is difficult due to varied and overlapping clinical presentation. Rare foreign bodies in the aero-digestive tract pose challenges in diagnosis and treatment.</p><p class="abstract"><strong>Methods:</strong> This was a retrospective observational study on thirty patients with aerodigestive foreign bodies who visited our hospital from July 2015 to October 2017.  </p><p class="abstract"><strong>Results:</strong> Maximum number of cases was seen in age group of 0-5 years. The male to female ratio was 2:1. Among various types of foreign bodies, majority were metallic (43.3%). The most common site was cricopharynx (53.3%) followed by bronchus (26.6%) and esophageal (16.6%). The most common procedure done was hypopharyngoscopy (53.3%).</p><p class="abstract"><strong>Conclusions:</strong> Aerodigestive tract foreign bodies are one of the emergencies that have considerable mortality and morbidity. High degree of skill and suspicion are required by surgeon for the management of foreign body.</p>

scholarly journals Endoscopic removal of foreign bodies from the upper aerodigestive tract: a retrospective study from a tertiary care hospital

2019 ◽  
Vol 5 (4) ◽  
pp. 960
Author(s):  
Sreeja Raj Vellamparambil ◽  
Arjun Gopinath Menon ◽  
Ariyamparambil Rajagopalan Vinayakumar
Keyword(s):  
Retrospective Study ◽  
Foreign Body ◽  
Digestive Tract ◽  
Clinical Examination ◽  
Foreign Bodies ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Aerodigestive Tract ◽  
Care Hospital ◽  
Upper Aerodigestive Tract

<p class="abstract"><strong>Background:</strong> Foreign bodies (FB) in the upper aero-digestive tract pose major challenges to the otorhinolaryngologist in both diagnosis and management. Aspirated and ingested foreign bodies are often emergencies, leading to inadequate study, poor preparation and improper attempts at removal. A retrospective analysis was done on cases which were managed for the upper aero-digestive tract FBs in a tertiary care hospital in South India and the result is presented in this article.</p><p class="abstract"><strong>Methods:</strong> Retrospective study was done on 100 patients diagnosed as cases of foreign body in upper aerodigestive tract on the basis of detailed history, clinical examination and radiological investigation. They underwent per oral endoscopy under general anaesthesia for retrieval of foreign body.  </p><p class="abstract"><strong>Results:</strong> Age group more prone for foreign body ingestion or aspiration was &lt;10 years and &gt;50 years. Most common site of impaction in oesophagus is cricopharynx and in airway is right bronchus. Most common type of FB is chicken bone. Most common symptom in FB ingestion is FB sensation and in case of FB aspiration it is cough. Most (82%) of the FBs were radio opaque.</p><p class="abstract"><strong>Conclusions:</strong> Accurate history and clinical examination were the keystones in diagnosis and prevention of complications of FB lodgement in aerodigestive tract. Negative history and or normal imaging do not rule out a foreign body.</p>

scholarly journals The Utility of the Maxillary Heuwieser for Oropharyngeal Foreign Body Removal Under Nebulized Local Anesthesia: A Case Series

2020 ◽  
pp. 014556132090632
Author(s):  
Weitao Wang ◽  
Glenn Todd Schneider ◽  
Alexis Strohl
Keyword(s):  
Health Care ◽  
Foreign Body ◽  
Local Anesthesia ◽  
Health Care Costs ◽  
Foreign Bodies ◽  
Case Series ◽  
Aerodigestive Tract ◽  
Upper Aerodigestive Tract ◽  
Flexible Laryngoscopy ◽  
Care Costs

We describe a novel and safe use of existing instrumentation in the removal of select foreign bodies in the upper aerodigestive tract to minimize health-care costs. A retrospective review of 4 cases involving visualized upper aerodigestive tract foreign bodies were identified via flexible laryngoscopy and extracted under local anesthesia from 2016 to 2018. All 4 patients were not in any airway distress and underwent successful removal of the foreign body, which included 2 fishbones, a sewing pin, and a wire bristle with a maxillary Heuwieser or giraffe instrument under flexible laryngoscopy visualizing using local anesthesia without complications. No foreign bodies were dislodged. The use of a maxillary Heuwieser and flexible laryngoscopy visualization is safe, allows for removal of otherwise difficult to reach foreign bodies at the bedside, improving patient comfort, obviates the need for general anesthesia to the patient, and minimizes health-care costs.

Multifocal bigerminal mature teratomas of the head and neck

2006 ◽  
Vol 120 (11) ◽  
pp. 967-969 ◽  
Author(s):  
A Delides ◽  
F Sharifi ◽  
E Karagianni ◽  
A Stasinopoulou ◽  
E Helidonis
Keyword(s):  
Head And Neck ◽  
Recent Literature ◽  
Aerodigestive Tract ◽  
Deep Neck Infection ◽  
Histological Classification ◽  
Upper Aerodigestive Tract ◽  
Neck Infection ◽  
The Past ◽  
Congenital Tumours

Teratomas and dermoids or hairy polyps of the head and neck are rare congenital tumours, often confused and reported to appear as single masses, that may cause upper aerodigestive tract impairment. Their histological classification, origin and embryological basis of development have been a topic of debate in the past and recent literature.We report a case of an infant presenting with a multifocal bigerminal teratoma in the nasopharynx and the neck, causing a deep neck infection, and discuss the unique clinicopathological aspects of this case.

Unusual Presentations of Penetrating Foreign Bodies of the Upper Aerodigestive Tract

1983 ◽  
Vol 92 (4_suppl) ◽  
pp. 32-44 ◽  
Author(s):  
Kenneth Remsen ◽  
Hugh F. Biller ◽  
William Lawson ◽  
Max L. Som
Keyword(s):  
Foreign Body ◽  
Foreign Bodies ◽  
Vascular Complications ◽  
Aerodigestive Tract ◽  
Review Of The Literature ◽  
Upper Aerodigestive Tract ◽  
The Status ◽  
Overall Mortality

Only a small number of ingested foreign bodies perforate the esophagus and even a smaller fraction migrate extraluminally. Four such penetrating and migrating foreign bodies of the upper aerodigestive tract are presented. Review of the literature revealed 321 cases of penetrating ingested foreign bodies, of which 252 remained intraluminal and 43 were found extraluminally, with the status of the remainder indeterminate. Analysis revealed that an intraluminal penetrating foreign body carried a higher overall mortality than one that migrated extraluminally. Although intraluminal and extraluminal penetrating foreign bodies may remain quiescent for years before presenting a complication, no correlation existed between mortality and the duration of the foreign bodies' retention. The greatest mortality was seen with vascular complications followed by diffuse and local suppurative processes. The overall mortality was significantly reduced in the postantibiotic era.

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