FOREIGN BODIES IN ENT

An infant or young child may put an object in his or her ears, nose or mouth

Objects in the mouth may be swallowed or breathed (aspirated) into the lungs

Objects in the ears and nose can make it hard to hear or breathe and can cause infection

FOREIGN BODIES IN THE EAR:

Foreign bodies in the ear canal be anything a child can push into his or her ear

Some of the items that are commonly found in the ear canal include

Food

Insects

Toys

Buttons

Pieces of crayon

Small batteries

« Some objects placed in the ear may not cause symptoms

« Other objects such as food and insects may cause pain in the air,redness or drainage

« Hearing may be affected if the object is blocking the ear canal

Techniques that may be used to remove the object from the ear canal:

Instruments such as long, thin tweezers or forceps may be put in the ear to grab and remove object

Magnets are sometimes used to remove the object if it is metal

The ear canal may be flushed with water

A machine with suction may be used to help pull the object out

After removal of the object, re-examine the ear to determine if there has been any injury to the ear canal

Antibiotic drops for the ear prescribed to treat any possible outer ear infections

FOREIGN BODIES IN THE NOSE:

Objects that are put into the childs nose are usually soft things

These include

Ÿ Tissue

Ÿ Clay

Ÿ Pieces of toys

Ÿ Erasers

« The most common symptom of a foreign body in the nose is nasal drainage

« Often has a bad odour

« In some cases, the child may also have a bloody nose

Techniques :

Sedating the child is sometimes needed to remove the object successfully

Suction machines with tubes attached may be used

Instruments may be inserted in the nose

The object may be blown out of the nose

After removal of the object, prescribe nose drops or Antibiotic ointment to treat any possible infections

FOREIGN BODIES IN THE THROAT :

A foreign body in the throat can cause choking and is a medical emergency that needs immediate attention. The foreign body can get stuck in many different places within the Airway.

According to the American Academy of Pediatrics death by choking  is leading cause of death and injury among children younger than 4 yrs of age

Ÿ Seeds                         

Ÿ Toy parts

Ÿ Grapes

Ÿ Hot dogs

Ÿ Pebbels

Ÿ Nuts

Ÿ Buttons

Ÿ Coins

Symptoms that may mean a child is choking

« Choking or gagging when the object is first inhaled

« Coughing at first

« Wheezing (A whistling sound usually made when the child breaths out)

 Symptoms may mean that the foreign body is still blocking an airway

« Stridor ( A high pitched sound usually heard when the child breathes)

« Cough that gets worse

« Child unable to speak

« Pain in the throat area or chest

« Hoarse voice

« Blueness around the lips

« Not breathing

« The child becoming unconscious

If the FB is visualised in the oropharynx and the patient can tolerate the procedure, removal may be attempted using Magill forceps. Otherwise, removal should be attempted with endoscopy under GA (either via pharyngoscopy / laryngoscopy or rigid oesophagoscopy).

The urgency of endoscopy is outlined below:

  • Emergency endoscopy
    • Any red flag signs
    • Any sharp or long (>5cm) object in the oesophagus
  • Urgent endoscopy (within 24 hours)
    • Oesophageal obstruction (unable to swallow saliva)
    • Blunt oesophageal FB
    • Magnets proximal to the duodenum
  • Non-urgent endoscopy
    • Disc or cylindrical batteries which have passed into stomach without signs injury
    • coins may be observed for upto 24 hours before removal if asymptomatic

To prevent choking:

Cut foods into small pieces

Never let small children run, play or lie down while eating

Keep coins and small items out of reach of your children

Read warning labels on toys

Learn first aid for choking

Submitted by

P.Bharathi

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