Heim Steven W, Maughan Karen L
University of Virginia School of Medicine, Charlottesville, Virginia 22908, USA.
Am Fam Physician. 2007 Oct 15;76(8):1185-9.
Foreign bodies in the ear, nose, and throat are occasionally seen in family medicine, usually in children. The most common foreign bodies are food, plastic toys, and small household items. Diagnosis is often delayed because the causative event is usually unobserved, the symptoms are nonspecific, and patients often are misdiagnosed initially. Most ear and nose foreign bodies can be removed by a skilled physician in the office with minimal risk of complications. Common removal methods include use of forceps, water irrigation, and suction catheter. Pharyngeal or tracheal foreign bodies are medical emergencies requiring surgical consultation. Radiography results are often normal. Flexible or rigid endoscopy usually is required to confirm the diagnosis and to remove the foreign body. Physicians need to have a high index of suspicion for foreign bodies in children with unexplained upper airway symptoms. It is important to understand the anatomy and the indications for subspecialist referral. The evidence is inadequate to make strong recommendations for specific removal techniques.
家庭医学中偶尔会见到耳、鼻、咽喉异物,通常发生在儿童身上。最常见的异物是食物、塑料玩具和小家居用品。由于通常未观察到致病事件、症状不具特异性且患者最初常被误诊,诊断往往会延迟。大多数耳、鼻异物可由经验丰富的医生在诊室取出,并发症风险极小。常见的取出方法包括使用镊子、水冲洗和吸引导管。咽部或气管异物属于医疗急症,需要外科会诊。X线检查结果通常正常。通常需要进行软性或硬性内镜检查以确诊并取出异物。对于有不明原因上呼吸道症状的儿童,医生需要高度怀疑有异物存在。了解解剖结构及转至专科医生处就诊的指征很重要。现有证据不足以对特定的取出技术给出有力推荐。