Karimnejad Kaveh, Nelson Erik J, Rohde Rebecca L, Costa Dary J
1 Department of Otolaryngology-Head and Neck Surgery, Saint Louis University School of Medicine, St. Louis Missouri, USA.
2 Indiana University, School of Public Health, Bloomington, Indiana, USA.
Ann Otol Rhinol Laryngol. 2017 Nov;126(11):755-761. doi: 10.1177/0003489417731578. Epub 2017 Sep 28.
To compare pediatric external auditory canal (EAC) foreign body extraction outcomes by clinical setting and identify factors predictive of successful removal.
Retrospective review of pediatric patients with EAC foreign bodies to a single institution emergency department (ED) and otolaryngology clinic (OTO) between January 2010 and April 2015. Patient characteristics, foreign body type, removal attempts, instrumentation utilized, and complications were evaluated with respect to clinical setting and patient outcome.
In all, 1197 patients with EAC foreign bodies were identified, 759 (63%) of whom presented primarily to the ED. Successful removal was achieved in OTO in 92.9% of cases and the ED in 67.9% of cases. Beads and spherical objects had the overall lowest rates of successful removal. Likelihood of removal decreased significantly after one unsuccessful attempt. Complications were reported in 35.7% of patients undergoing removal in the ED and 5.0% of patients undergoing removal in the otolaryngology clinic.
Patients commonly present to the ED for removal of EAC foreign bodies. Referral to an otolaryngologist is recommended if the object is spherical or after one unsuccessful attempt at removal.
比较在不同临床环境下小儿外耳道（EAC）异物取出的结果，并确定预测成功取出的因素。
回顾性分析2010年1月至2015年4月间在某单一机构急诊科（ED）和耳鼻喉科诊所（OTO）就诊的患有EAC异物的小儿患者。就临床环境和患者结局评估患者特征、异物类型、取出尝试、使用的器械及并发症。
共识别出1197例患有EAC异物的患者，其中759例（63%）主要就诊于急诊科。耳鼻喉科诊所92.9%的病例成功取出异物，急诊科为67.9%。珠子和球形物体的总体成功取出率最低。一次取出尝试失败后，取出的可能性显著降低。在急诊科接受取出治疗的患者中有35.7%报告发生并发症，在耳鼻喉科诊所接受取出治疗的患者中有5.0%报告发生并发症。
患者通常因取出EAC异物就诊于急诊科。如果异物是球形或一次取出尝试失败，建议转诊至耳鼻喉科医生处。
