Actualities of Management of Aural, Nasal, and Throat Foreign Bodies

Abstract

Background: Foreign bodies (Fbs) in the ear, nose, and throat (ENT) are common presentations in healthcare settings worldwide.

Aim: This study was carried out to review the modes of presentation, management, and outcome of inserted Fbs in our setting.

Subjects and Methods: A 5‑year retrospective study of cases of ENT Fbs managed at two referral hospitals in Abuja Nigeria. The analysis was done with Chi‑square and Pearson correlation.

Results: Five hundred and ninety‑four patients aged 0–75 years, M:F = 1.1 (295 vs. 299) were reviewed. Prevalence was predominantly among the under 5 s; 286/594 (P = 0.001). ENT Fbs were 356/594 (59.9%), 167/594 (28.1%) and 71/59 (12.0%), respectively. Cotton wool 133/356 (37.4%) and beads 75/356 (21.1%) constituted most aural Fbs. Beads 45/167 (27.0%) and grains/seed 37/167 (22.1%) were the most common nasal Fbs while fish bones 38/71 (53.5%) and piece of metals 12/71 (16.9%) were dominant in the throat. Most cases of aural and nasal Fbs were asymptomatic. Ear syringing was the most common method for removal of aural Fbs 216/594 (60.7%) and instrumentation under direct vision for nasal Fbs 153/167 (91.6%). Furthermore, 52/71 (73.2%) of throat Fbs were removed under general anesthesia. ENT complications observed included bruises, lacerations, perforations, Epistaxis, and a case of respiratory failure. Delayed presentation (beyond 24 h) was seen in 489/594 (82.3%) of cases while failed previous attempts by untrained hands constituted 353/594 (59.4%). A strong correlation between complications and duration of Fbs insertion (R2 = 0.8759) was established.

Conclusions: Fbs in ENT are common especially among children below 5 years. Majority presented beyond 24 h, and there was a strong correlation between duration of Fbs insertion and associated complications. Repeated failed attempts and delayed referrals to otorhinolaryngologists from peripheral centers were also contributing factors to increased morbidity and hence the need for awareness. 

Keywords: Aural, Foreign bodies, Laryngeal, Nasal, Otorhinolaryngologist, Pharyngeal, Throat