Oya Ryohei, Horii Arata, Uno Atsuhiko, Kawasaki Yoshiaki, Inohara Hidenori
Department of Otorhinolaryngology Head and Neck surgery, Osaka General Medical Center, 3-1-56 Bandaihigashi, Sumiyoshi-ku, Osaka, Japan; Department of Otorhinolaryngology Head and Neck surgery, Osaka University Graduate School of Medicine, 2-15 Yamadaoka, Suita-shi, Osaka, Japan.
Department of Otorhinolaryngology Head and Neck surgery, Niigata University Graduate School of Medical and Dental Science, 1-754 Asahimachidori, Chuo-ku, Niigata, Japan.
Auris Nasus Larynx. 2019 Aug;46(4):618-623. doi: 10.1016/j.anl.2018.11.007. Epub 2018 Dec 1.
Foreign bodies (FBs) in ear, nose, and throat (ENT) are common ENT emergencies but are sometimes life-threatening. However, FBs could be avoidable by the efficient announcement about the risk of these occurrence to the public. Fish bones are commonly found as throat FBs, and small toys are commonly found as pediatric ear and nose FBs. We hypothesized that there were relationships between the occurrence of FBs and sociocultural/geographical conditions. The purpose of this study is to clarify the risk factors of FBs in ENT regions related to eating customs and weather conditions.
From April 2009 to March 2014, 94,479 patients visited the Chuo Emergency Clinic (CEC) in Osaka, which is a local emergency center for Osaka prefecture in Japan. Among them, 3229 patients with throat FBs, 577 children (0-15 years of age) with ear FBs, and 1999 children (0-15 years of age) with nose FBs were enrolled into the present study. Monthly trends in the number of throat FBs were examined in relation to fish eating customs. The monthly average of the daily ratio of pediatric patients with ear or nose FBs to the total number of patients were examined in relation to weather parameters using a database of the Japan Meteorological Agency.
The incidence of throat FBs was significantly higher in July and January (p<0.05, analyzed by ANOVA and Tukey-Kramer test), presumably because Japanese people have more chances to eat fish in these months due to the traditional fish-eating customs. There was also a significant correlation between the number of pediatric patients with ear and nose FBs and the bad weather parameters including daily rainfall (r=0.76, p=0.0043; r=0.57, p=0.050, respectively, analyzed by the Pearson product-moment correlation coefficient). This is because children would spend longer time inside on rainy days, which increases the chance of putting a small toy part in the ear and nose.
FBs in throat and ear/nose occurred more frequently in the specific periods to eat fish and rainy days, respectively. Therefore, public announcement on the risk of occurrence of FBs based on sociocultural and geographical data is helpful to prevent FBs.
耳鼻咽喉（ENT）异物是常见的ENT急症，但有时会危及生命。然而，通过向公众有效宣传这些情况发生的风险，异物是可以避免的。鱼骨是常见的咽喉部异物，小玩具则是常见的儿童耳部和鼻部异物。我们推测异物的发生与社会文化/地理条件之间存在关联。本研究的目的是阐明与饮食习惯和天气状况相关的ENT区域异物的危险因素。
2009年4月至2014年3月，94479名患者前往日本大阪的中央急诊诊所（CEC）就诊，该诊所是大阪府的当地急诊中心。其中，3229例咽喉部异物患者、577例（0 - 15岁）耳部异物儿童和1999例（0 - 15岁）鼻部异物儿童被纳入本研究。研究了咽喉部异物数量的月度趋势与吃鱼习惯的关系。利用日本气象厅的数据库，研究了耳部或鼻部异物儿童患者日比例的月平均值与天气参数的关系。
咽喉部异物的发生率在7月和1月显著更高（p<0.05，通过方差分析和Tukey - Kramer检验分析），推测是因为由于传统的吃鱼习惯，日本人在这几个月有更多机会吃鱼。耳部和鼻部异物儿童患者数量与包括日降雨量在内的恶劣天气参数之间也存在显著相关性（分别通过Pearson积矩相关系数分析，r = 0.76，p = 0.0043；r = 0.57，p = 0.050）。这是因为儿童在雨天会在室内待更长时间，这增加了将小玩具部件放入耳朵和鼻子的几率。
咽喉部和耳部/鼻部异物分别在特定的吃鱼时期和雨天更频繁发生。因此，基于社会文化和地理数据对异物发生风险进行公众宣传有助于预防异物。
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