Belaiche Alicia, Lewis Trevor A, Pugi Jakob, Bogatchenko Mariya, Johnson Liane B, Rosaasen Trina C, Nguyen Lily H P
Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada.
Department of Otolaryngology-Head and Neck Surgery, McMaster University, Hamilton, Ontario, Canada.
Otolaryngol Head Neck Surg. 2025 Aug;173(2):385-391. doi: 10.1002/ohn.1275. Epub 2025 Apr 29.
Characterize the demographic and clinical features of pediatric sharp foreign body aspiration (FBA).
Twenty-four-year retrospective chart review.
Four tertiary-care centers across four Canadian provinces.
A retrospective chart review was conducted on pediatric patients who underwent rigid bronchoscopy for sharp FBA below the vocal cords at the McGill University, McMaster University, University of Alberta, and Dalhousie health centers from January 1, 2000, to November 30, 2023.
In total, 48 patients (27 males and 21 females, mean age of 10.1 years) met the inclusion criteria. Thumbtacks were the most common aspirated objects (66.7%). The mean age for thumbtack aspiration was 11.6 years, which was significantly higher than the 7.0-year mean for other sharp FBAs (P = .0263). Subgroup analysis of patients who resided in an Indigenous territory had a significantly greater rate of thumbtack aspiration (89.3%, P = .0001). Sharp FBA presented with typical symptoms of FBA with the addition of a higher incidence of chest pain (27.1%) and hemoptysis (18.8%), and it was characterized by a higher incidence of radiopaque FBs on chest radiography (89.6%). Most complications, including postoperative atelectasis (27.1%), pneumothorax (4.2%), perforation (2.1%), and vocal cord hematoma (2.1%), were observed with thumbtacks.
This is the largest pediatric study on sharp FBA in America, addressing a significant gap in the literature. Considering the trends and patient demographics identified in this study and in the literature globally, geographical or cultural variations may influence the nature of sharp FBA in pediatric populations. Insights from this study can inform future prevention programs.
描述儿童尖锐异物吸入（FBA）的人口统计学和临床特征。
24年回顾性病历审查。
加拿大四个省份的四个三级医疗中心。
对2000年1月1日至2023年11月30日在麦吉尔大学、麦克马斯特大学、阿尔伯塔大学和达尔豪斯健康中心因声带以下尖锐FBA接受硬质支气管镜检查的儿科患者进行回顾性病历审查。
共有48例患者（27例男性和21例女性，平均年龄10.1岁）符合纳入标准。图钉是最常见的吸入异物（66.7%）。图钉吸入的平均年龄为11.6岁，显著高于其他尖锐FBA的平均年龄7.0岁（P = 0.0263）。居住在原住民地区的患者亚组中图钉吸入率显著更高（89.3%，P = 0.0001）。尖锐FBA表现为FBA的典型症状，胸痛（27.1%）和咯血（18.8%）的发生率更高，胸部X线检查显示不透射线异物的发生率更高（89.6%）。大多数并发症，包括术后肺不张（27.1%）、气胸（4.2%）、穿孔（2.1%）和声带血肿（2.1%），都与图钉有关。
这是美国关于尖锐FBA的最大规模儿科研究，填补了文献中的重大空白。考虑到本研究和全球文献中确定的趋势及患者人口统计学特征，地理或文化差异可能影响儿科人群尖锐FBA的性质。本研究的见解可为未来的预防计划提供参考。
