Ansley J F, Cunningham M J
Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, USA.
Pediatrics. 1998 Apr;101(4 Pt 1):638-41. doi: 10.1542/peds.101.4.638.
To determine the proper treatment of children and adolescents with foreign bodies of the external auditory canal (EAC).
Retrospective case series.
Specialty care referral hospital.
All patients younger than 18 years of age who presented in the emergency ward or office setting with a foreign body of the EAC during a 5-year period.
One hundred ninety-one patients with aural foreign bodies were identified. Age at presentation ranged from 10 months to 17 years with 141 patients (74%) younger than 8 years old. Twenty-seven different objects were encountered with pebbles, beads, insects, and plastic toys the most common. Fifty-seven (30%) of the patients required surgical removal of the aural foreign body under general anesthesia.
Adequate immobilization and proper instrumentation allow the uncomplicated removal of many EAC foreign bodies in the pediatric population. The use of general anesthesia is preferred in very young children and in children of any age with aural foreign bodies whose contour, composition, or location predispose to traumatic removal in the ambulatory setting. Criteria for otolaryngologic referral and consideration of operative microscopic removal are outlined.
确定外耳道（EAC）异物患儿及青少年的恰当治疗方法。
回顾性病例系列研究。
专科护理转诊医院。
5年间在急诊病房或门诊因EAC异物就诊的所有18岁以下患者。
共识别出191例耳部异物患者。就诊年龄从10个月至17岁，其中141例（74%）年龄小于8岁。共发现27种不同异物，最常见的是鹅卵石、珠子、昆虫和塑料玩具。57例（30%）患者需要在全身麻醉下手术取出耳部异物。
充分固定和适当的器械操作可使儿科患者的许多EAC异物得以顺利取出。对于非常年幼的儿童以及任何年龄的耳部异物患儿，若其异物的外形、成分或位置易导致在门诊环境中进行创伤性取出，则首选全身麻醉。文中概述了耳鼻喉科转诊标准以及手术显微镜下取出的考量因素。
