Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada.
Department of Otolaryngology- Head and Neck Surgery, McGill University, Montreal, Quebec, Canada.
J Otolaryngol Head Neck Surg. 2020 Sep 29;49(1):70. doi: 10.1186/s40463-020-00470-1.
Foreign body ingestion is a common problem in pediatrics. Each foreign body can present its' own unique challenges during removal, and we present the management of an ingested Spotted Tussock Moth (Lophocampa maculata), more commonly known as a caterpillar.
An 18-month-old boy presented to the emergency department with difficulty handling secretions and odynophagia. It was reported he had placed a caterpillar in his mouth and then spat it out. On examination, hundreds of miniscule filaments (setae) were seen embedded in his lips and tongue. Our service was consulted out of concern for airway involvement. The patient was taken to the operating room where a direct laryngoscopy under general anesthesia with spontaneous ventilation was performed to confirm the setae were confined to the anterior tongue and lips. Once we were satisfied the airway was stable, the airway was secured, and we then began to remove the setae. The initial method used was to use Adson-Brown forceps to remove the setae, however this proved difficult and time-consuming given the volume of setae and how thin the setae were. Ultimately, a more effective technique was developed: a 4 × 4 AMD-RITMES® gauze was applied to the mucosa in order to dry up any secretions and then a piece of pink, waterproof BSN medical® tape was applied to the mucosa. After 3 s of contact it was removed. This technique was then repeated and was used to remove the vast majority of the setae.
To our knowledge, we have described the first technique to remove the caterpillar setae from the oral cavity mucosa in a fast, safe and efficient manner.
异物吞食是儿科的常见问题。每种异物在取出时都可能带来独特的挑战，我们报告一例吞食松毛虫（Lophocampa maculata）后需取出的病例，松毛虫又名毛毛虫。
一名 18 个月大的男孩因分泌物处理困难和咽痛就诊于急诊科。据报道，他曾将毛毛虫放入口中，然后吐出。检查时，发现数百根微小的细丝（刚毛）嵌入他的嘴唇和舌头上。因担心气道受累，我们的科室被咨询。患者被带到手术室，在全身麻醉下进行直接喉镜检查并自主通气，以确认刚毛局限于舌前和唇。当我们确定气道稳定后，固定气道，然后开始去除刚毛。最初使用的方法是用 Adson-Brown 镊子去除刚毛，但鉴于刚毛数量和刚毛的细度，这种方法既困难又耗时。最终，开发了一种更有效的技术：将 4×4 AMD-RITMES®纱布应用于黏膜以吸干任何分泌物，然后将一块粉色防水 BSN medical®胶带贴于黏膜。接触 3 秒后将其移除。然后重复此技术，用于去除大部分刚毛。
据我们所知，我们首次描述了一种快速、安全、有效的方法，用于从口腔黏膜上去除毛毛虫的刚毛。
