Department of Otolaryngology, Head and Neck Surgery, Rabin Medical Center and Schneider Children's Medical Center of Israel, 4920235 Petach Tikva, Israel.
Department of Otolaryngology, Head and Neck Surgery, Rabin Medical Center and Schneider Children's Medical Center of Israel, 4920235 Petach Tikva, Israel.
Am J Emerg Med. 2021 Dec;50:356-359. doi: 10.1016/j.ajem.2021.08.045. Epub 2021 Aug 21.
Nasal foreign bodies (NFB) are commonly seen in pediatric patients seeking medical attention in the emergency department (ED). We aim to describe the occurrence, clinical presentation and management, of these cases, and to assess various risk factors for complications.
A retrospective analysis of a computerized patient directory of 562 children admitted to the emergency department during a 10-year period, with NFB, in a tertiary pediatric hospital.
Upon admittance, most of the children (82%) were asymptomatic. Among the symptomatic children (18%), the primary symptoms were nasal discharge (10%), epistaxis (8%) and pain (4%). Younger children (under 4 years) were more likely to insert organic materials, compared to older children. Younger children were also admitted sooner to the emergency department and were more likely to present with nasal discharge. The overall complication rate was 5%. None of the children had aspirated the foreign body. Complications included infection (2%), necrosis (0.7%), septal perforation (0.5%), deep mucosal laceration (1.5%) and loss of foreign body (1.9%). Significantly higher rates of symptoms and complications were associated with button batteries. Increased risk for complications were observed according to type of foreign body, multiple attempts to remove it, posterior insertion and left-side insertion.
Nasal foreign bodies in children are common. Mostly, patients are asymptomatic, therefore a high index of suspicion is required, for quick diagnosis and safe removal, without complications.
鼻腔异物（NFB）在儿科急诊就诊的患儿中较为常见。我们旨在描述这些病例的发生、临床表现和处理方法，并评估各种并发症的风险因素。
对一家三级儿童医院急诊部在 10 年期间收治的 562 例鼻腔异物患儿的计算机化患者目录进行回顾性分析。
入院时，大多数患儿（82%）无症状。在有症状的患儿中（18%），主要症状为鼻腔分泌物（10%）、鼻出血（8%）和疼痛（4%）。与年长儿相比，年幼的儿童（4 岁以下）更易塞入有机材料。年幼的儿童也更早地被收入急诊部，且更可能出现鼻腔分泌物。总的并发症发生率为 5%。没有患儿将异物吸入。并发症包括感染（2%）、坏死（0.7%）、鼻中隔穿孔（0.5%）、深部黏膜裂伤（1.5%）和异物丢失（1.9%）。与纽扣电池相比，症状和并发症的发生率显著更高。根据异物类型、多次尝试取出、后入路和左侧入路，并发症的风险增加。
儿童鼻腔异物较为常见。大多数患者无症状，因此需要高度怀疑，以便快速诊断和安全取出，避免并发症。
