Removal of external auditory canal foreign bodies in the pediatric emergency department - A retrospective comparison study. (September 2022) - Weksler, Chen Weinstein
Abstract: Introduction: The removal of foreign bodies from the external auditory canal (EAC) is a common cause of referral to the pediatric emergency department (PED). The attempt at removal of foreign bodies can lead to complications ranging from mild canal injuries and through severe inner ear damage. The removal requires knowledge and expertise. Ear, Nose and Throat (ENT) physicians are considered the most qualified to remove these foreign bodies. The decision of when the ENTs need to be involved is debated. Methods: A retrospective analytical comparison study was conducted. The study included all children admitted to the PED for EAC foreign body removal, between the years 2009–2019. Results: A total of 333 children were included in the study. The mean age was 6.53 years. Success rate of the procedure on the first attempt performed by pediatricians was 82.4% and when performed by ENT physicians the success rate was 96.1%. However, when those with a previous attempt of removal were removed from the study the success rates of PED physicians were 93.9% and of ENT physicians were 96.8%. Conclusion: This single center study shows that with correct case evaluation, the PED physician can and should succeed in EAC FB removal with minimal complications and comparable to ENT performance. If a first attempt failed, an ENT consult is warranted. Highlights: Removal of External auditory canal foreign bodies is a common procedure in the pediatric emergency department. This procedure can cause complications and requires knowledge and skilled personnel to perform. ENT physicians have a high percentage of success in foreign body removal. A prior attempt at removal will make success less likely in the pediatric emergency department. If no prior removal was attempted – a skilled pediatric emergency physician can likely successfully remove the foreign body.