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<b>Objective:</b> The aim of this study was to evaluate cases of of ear, nose and pharyngeal (ENT) foreign body (FB) in pediatric patients referred to the pediatric emergency department of the Department of Otorhinolaryngology in Tokat State Hospital (Turkey). <br><b>Methods:</b> The paper comprises a retrospective study of all ENT foreign bodies presented to the pediatric emergency Department of Otorhinolaryngology in Tokat State Hospital (Turkey) between January 1, 2012 and December 31, 2018. Subject to evaluation were also demographic and clinical characteristics of the patients, types and anatomic locations of FBs, locations of FB by age groups, the method used to remove FBs and the distribution of FB cases by months. <br><b>Results:</b> A total of 829 FB cases were evaluated in this study. The mean age of patients was 47.8 ± 31.4 months. Of all patients, 404 (48.5%) were male, and 425 (51.2%) were female. The nose (58.7%) and the ear (20.2%) were the most common anatomical locations followed by mouth/pharynx/tonsil (12.3%), esophagus (6.2%) and the laryngotracheobronchial tree (2.4%). The most common FBs in different locations were beads in the nose (30.8%), beads in the ear (32.1%), fishbones in the mouth/pharynx/tonsil (56.8%), nuts and peanuts in laryngotracheobronchial tree (70%) and a coin/disc battery in the esophagus (80.7%). <br><b>Conclusion:</b> FB in ENT is among the emergency conditions that require different diagnostic and treatment approaches based on anatomic localizations. Proper vision, adequate equipment and immobilization are important in the removal of ENT foreign bodies in children.

Competing Interests: None

Foreign bodies to the ear, nose, and throat often can be managed in the emergency department, particularly if the patient offers a history consistent with foreign body and is calm and compliant with the examination and removal attempts. Tips for success include analgesia, adequate visualization, immobilization of the patient's head, dexterity and experience level of the provider, and minimizing attempts at removal. It is critical to recognize the risks involved with certain retained objects (button batteries or sharp objects) and when to call a consultant to help facilitate safe, successful removal of objects to the ear, nose, and throat., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Aims: Insertion of a foreign body in the nasal cavity is a very common incident in children. It is easily diagnosed, but the type of foreign body varies and extraction can sometimes be difficult, with risk of complications. The present study reports nasal foreign bodies seen in emergency in our ENT department, with an update on the state of knowledge., Materials and Methods: A prospective study between May and August 2011 included all patients admitted to the ENT emergency unit for nasal foreign body. Data comprised age, gender, circumstances of discovery, symptoms, type of foreign body, extraction method and complications., Results: Two hundred and sixty cases of nasal foreign body were included, representing 4.3% of all consultations in the unit. Mean age was 3 years (range: 1-16 years); the sex ratio was 1.4 (male predominance). The incident was reported by a family member or the actual child in 76.9% of cases (n=199), or discovered following nasal symptoms in 23.1% (n=61). The main types of foreign body were non-organic synthetic beads in 18.8% of cases and vegetable forms in 17.7%. Extraction was easy, using forceps, micro-hooks or suction, in 91.53% of cases. Complications comprised infection (n=48), epistaxis (n=18) and nasal septum perforation (n=1)., Conclusion: Nasal foreign bodies are a frequent accident in medical practice, especially in young children. They are generally harmless, but may incur complications if overlooked or when a button cell is involved, whence the importance of timely extraction. The best treatment, however, remains prevention., (Copyright © 2015 Elsevier Masson SAS. All rights reserved.)

Objectives: To evaluate 1875 cases of nasal foreign body (NFB) removal with regard to type of foreign body (FB), location, complications, techniques for removal, age and gender, and to present the results of the evaluation., Methods: Between 2006 and 2013, a total of 1875 NFBs were removed from 1870 children in ENT Services of Antalya Ataturk State Hospital and Izmir Tepecik Training - Research Hospital. A retrospective review was undertaken to evaluate the parameters related to the NFBs and their removal and the data were analyzed., Results: The most frequent NFBs were hard spherical objects and the most common locations to lodge were on the right side just anterior to the middle turbinate. Prolonged exposure increases the complication rate, and button batteries are particularly ominous as they drift into the airway, never observed. We found a higher incidence in patients between ages 2 and 5 years. The distribution of NFBs was 52.9% in boys and 47.1% in girls., Conclusions: NFBs are most commonly hard, round objects. Button batteries and penetrating FBs must be treated immediately. Complications from NFBs are rare but may be potentially serious or even life threatening., (Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)

Objective: The aim of this study was to determine the common presentations and management outcomes in case of nasal foreign body., Material and Method: A retrospective study was carried out over 5 years, from January 2008 to December 2012. The total number of patients was 43; maximum age was 9 years. Patient biodata, clinical presentation, type of foreign body and management outcome were obtained and analyzed from the medical records of the Universiti Sains Malaysia Hospital., Results: Of the total 43 patients, 60.5% were male and 39.5% female. The most frequent age at which nasal foreign bodies were found was 3 years (48.83%) and the least frequent age bracket was 7-9 years (2.33%). Most patients had foul smelling nasal discharge (34.88%) or were asymptomatic (34.88%); the least common presentation was nasal discomfort (2.33%). Seeds (23.26%) were the most common foreign body, followed by rubber and batteries (16.28%). In most cases (58.14%), the foreign body had been inserted into the right nostril; 39.53% were inserted into the left nostril, and 2.33% were bilateral. Foreign bodies were removed under general and local anesthesia in 53.49% and 41.86% of cases respectively; 4.65% were dislodged spontaneously., Conclusion: Nasal foreign bodies are encountered daily in our routine clinical practice in the pediatric age group. General anesthesia is required in uncooperative agitated patients to avoid complications., (Copyright © 2015 Elsevier Masson SAS. All rights reserved.)

Background: The ingestion of foreign body is a common problem in children, some of which may cause damage or may be associated with toxicity., Objective: To evaluate and analyze the pattern of foreign bodies in children in the esophagus, ears and nose with review of the techniques for removal in the emergency department., Methods: From Sept 1, 2008 to May 30, 2010, a review of all children with foreign bodies in the esophagus, ears and in the nose was done to assess the patterns and treatment outcomes. The source and the study group were (N-72). Data concerning socio- demographics, characterization, presenting symptoms and signs, techniques of retrieval and outcomes were extracted and filled in a previously prepared protocol sheet. Descriptive analysis was done using SPSS- computer statistical software., Results: During the study period, 72 children, victims of foreign bodies in the esophagus, ears and in the nose were included in the study. Of these 44 (61.1%), 28 (38.9%) were male and female children, respectively. The age ranged from 11 months to 14 years with (mean = 4 years). The most affected age group was between 0-5 years accounting for 46 (63.9%) followed by the age group between 6-10 years accounting for 20 (27.8%) of all cases. Males 44 (61.1%) were predominantly most affected than females 28 (38.8%). The location of foreign bodies in this study were in the ears 45 (62.5%), esophagus 17 (23.6%) and in the nose 10 (13.9%) in order of their frequency. Swallowed foreign bodies were successfully removed by Magill forceps. Foreign bodies in the ears and in the nose were removed by careful but different techniques depending on the type and the clinical condition of the patient at time of intervention., Conclusion: Our study revealed a higher number of patients with foreign bodies in the ears and in the esophagus. Only a small number ofpatients presented with FBS in the nose. Food items in the ears, in the nose and coins in the esophagus were items frequently observed. Early suspicion, early diagnosis and prompt intervention have attributed to reduce morbidities of major events.

Aim: Ear, nose and throat (ENT) foreign body (FB) injuries represent an emerging problem in the paediatric population because of their human and social costs. The aim of the study is the site-specific evaluation of FB injuries in the paediatric population referred to the emergency department of the Pediatric Hospital of Turin., Methods: This retrospective analysis was carried out sifting medical reports between 2002 and 2011. We collected information about 338 patients' FB characteristics, complications and hospitalisation., Results: The mean age was 4.2 ± 2.9 years. Nose and ear are the most involved anatomical sites, followed by pharynx, oesophagus and trachea-bronchi. The most common FBs are balls, beads and toys parts (29.6%), followed by fishbones (13.6%). A lower mean age is observed in tracheo-bronchial and oesophageal FBs. The 9.2% of cases reported complications., Conclusions: A quick and proper diagnosis followed by an effective treatment of FB injuries and their complication is mandatory. Surveillance registries have a key role in prevention and management of FB injuries; useful information can be obtained also for nurse and ENT specialist training in order to create professionals ready to recognise and manage FB injuries in the most effective way., (© 2014 The Authors. Journal of Paediatrics and Child Health © 2014 Paediatrics and Child Health Division (Royal Australasian College of Physicians).)

Background: The purpose of this study was to calculate nationwide incidence of emergency department (ED) visits for nasal foreign bodies, identify the most frequently encountered consumer products, and evaluate outcomes and demographic trends., Methods: The Nationwide Electronic Injury Surveillance System (NEISS) was evaluated for ED visits related to nasal foreign bodies for the most recent 5-year span available. Nationwide incidence was calculated, and the most frequent foreign bodies were identified and organized by demographics including age and gender., Results: A total of 6418 entries extrapolated to an estimated 198,566 ED visits nationwide were found. Out of individual case entries evaluated, median patient age was 3 years, and 42.7% of patients were male. Ninety-six percent (96.4%) of patients were released after examination/treatment. Jewelry beads comprised a plurality of nasal foreign bodies, followed by paper products and toys. Patients with nasal foreign bodies involving toys, building sets, pens/pencils, batteries, coins, and nails/screws were predominantly male, whereas patients with nasal foreign bodies involving jewelry, paper products, and buttons were predominantly female. Jewelry was the most common item for patients in most age groups; age-specific differences in the composition of remaining nasal foreign bodies were noted., Conclusion: A variety of consumer products carry inherent risks for becoming nasal foreign bodies, with nearly 200,000 ED visits over a 5-year period. Jewelry beads, paper products, and toys were the most common products noted. Speedy recognition and retrieval of these items and other objects noted is imperative for avoidance of deleterious sequelae. Demographic-specific trends noted and organized by age and gender may be an invaluable adjunct for patient history-taking and clinical examination., (© 2014 ARS-AAOA, LLC.)

Disc batteries as foreign bodies present challenges in both diagnosis and management and carry a high risk for complications. We describe a novel device for disc battery removal using a magnet and basic medical supplies readily available in the emergency department setting. We also review diagnosis, complications, and management recommendations for disc batteries as foreign bodies.

Objectives: Nasal foreign bodies (FBs) are common causes of pediatric emergency consultations. The different methods for removing nasal FBs have varying levels of efficacy. The aim of this study was to evaluate the safety and efficacy of a new device for nasal FB removal in children., Methods: A nasal occlusion device that uses modulated positive pressure to remove FBs was evaluated in a series of 18 patients ranging in age from 1 to 8 years diagnosed with a nasal FB during a period of 7 months., Results: The device successfully removed FBs in 17 (94.4%) of the 18 patients. In 12 of the cases (66.7%), the FB was removed during the first attempt. None of the patients had complications or sequelae at the time of removal or at the follow-up visit., Conclusions: The nasal occlusion device used in this study was found to be a promising, safe, effective, and easy to use tool for FB removal in a pediatric emergency room setting.

Objective: To investigate whether the prevalence of attention-deficit/hyperactivity disorder (ADHD) is higher in children presenting with nasal and aural foreign bodies than in the control group., Methods: The present study was conducted between April 2012 and December 2012 and included 60 pediatric patients presenting with self-inserted nasal and aural foreign bodies and 50 healthy controls aged between 3 and 9 years. The Conner Parent Rating Scale (CPRS) and Turgay's DSM-IV based ADHD and disruptive behavior disorders screening scale (T-DSM-IV-Scale) were used to investigate ADHD., Results: The difference between the patient group and the control group was significant with respect to the abnormal scores obtained from all the subscales (p < 0.05). In children between 5 and 9 years of age, the abnormal scores were significantly higher in the patients than the controls for all the subscales (p < 0.05). However, in children between 3 and 4 years of age, there were no significant differences between the patients and the controls for the scores obtained from all the subscales (p > 0.05). No statistically significant difference was found between the patients with a previous history of self-inserted foreign bodies and those without any history of foreign body insertion (p > 0.05)., Conclusions: The findings of our study demonstrated a possible association between the self-insertion of nasal and aural foreign bodies and ADHD. Clinicians should be aware of the possible presence of ADHD in children, especially in those patients between 5 and 9 years of age who present with self-inserted nasal and aural foreign bodies., (Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.)

Injuries and illness to the ears, nose, and throat are frequently seen in the emergency department. The emergency medicine physician must be proficient in recognizing these injuries and their associated complications and be able to provide appropriate management. This article discusses the most common otorrhinolaringologic procedures in which emergency physicians must be proficient for rapid intervention to preserve function and avoid complications. A description of each procedure is discussed, as well as the indications, contraindications, equipment, technique and potential complications., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Background: Nasal foreign bodies (NFBs) are a common occurrence, particularly in children between 2 and 4 years old. Many techniques have been developed to remove NFBs, though intranasal batteries, in particular, possess characteristics such as round shape, smooth surface, and limited visibility that make attempts at removal significantly more difficult. In the context of intranasal batteries, a considerable local soft tissue reaction and potential necrosis may exist to further complicate removal., Objective: To present a technique for removal of difficult intranasal foreign bodies that may be utilized by health care practitioners, particularly in the Emergency Department setting., Case Report: We present a case of a 4-year-old child presenting with intranasal battery with mucosal necrosis. After conventional techniques failed, we utilized a novel wire snare technique to dissect the NFB free from the nasal mucosa safely and in an atraumatic fashion., Conclusion: This technique is noted to be a rapid, atraumatic, and effective means for the removal of difficult NFBs., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Objective: To investigate the injury of button battery to nose and discuss its management., Method: Thirteen cases with button battery in nose were reviewed. After the removal of button battery, nasal cavity irrigations were carried out carefully by nasal endoscopy in all cases. Gelfoam full of erythromycin eye ointment was used to cover the injured mucous membrane., Result: Among all the cases, 10 got full recovery without any complication. There are 2 cases of synechia nasal and 1 case of septum perforation., Conclusion: Removal as soon as possible, careful cleaning and systemic drug are necessary. Nose bleed, septum perforation, adhesion and rhinostenosis should be noticed.

Nasal foreign bodies are common in children. Button batteries deserve particular interest due to the severity and precocity of the injuries they cause. The button battery represents a growing danger. Its small size and brilliant appearance make them attractive to children, often being introduced in the nose, ear or mouth. It is imperative that the community and physicians are aware of the risks it poses. Early diagnosis and immediate removal is essential. Their delay can lead to necrosis of the nasal mucosa and septal perforation. We report 10 cases of septal perforation due to button battery. We emphasize the dangers of nasal impaction and the need for quick removal to avoid long-term complications.

Background: Magnetic earrings are becoming a popular item for both adults and children. In recent years, there have been case reports describing how two magnetic rings become affixed to the nasal septum., Discussion: We report the use of two cardiac pacemaker magnets and two micro polypus forceps to remove the magnetic rings via induced magnetism., Conclusions: The use of magnetized instruments demonstrates a safe and effective way to remove impacted magnetic foreign bodies from the nose., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Background: Foreign body (FB) injury in children is becoming increasingly common in developing countries. Children tend to be curious and exploratory hence the easily accessible orifices tend to be at risk of this form of injury. This study is to determine the prevalence, treatment outcome and complication of foreign body injury to the ear, nose and throat in children., Materials and Methods: A retrospective study of all pediatric patients with FB in the ear, nose and throat (ENT) seen at the ENT surgery department and children emergency ward of our institution from January 2004 to December 2008. Demographic and clinical data were obtained from records of the patients and analyzed., Results: There were 202 children with ENT injuries within the period under study, 181 (89.60%) had FB injuries. There were 94 males (51.93%), 87 females (48.07%) male:female ratio of 1.1:1. Age ranged from 2 months -15 years with a mean of 3.71 ± 2.59 years, a mode of 3 years. Most of the patients were below age seven years, highest in the range 0-3 years (61.8%). The nose recorded the highest injury 88 (48.62%). Commonest FB was ornamental bead 51 (28.17%) found both in the ear and the nose. Fish bone constituted the highest FB in the laryngotracheobronchial (LTB) tree and the oesophagus. Twenty-three cases (12.7%) had emergency tracheostomy done., Conclusion: Foreign body injuries constitute a significant portion of pediatric ENT trauma in clinical practice. The under 3 years are most affected. There is need for more public education of parents and care givers so as to prevent this avoidable injury.

Objective: Ear nose and throat foreign bodies in children are one of the most common emergencies faced by otorhinolaryngologists. Our objective in the study conducted in the otolaryngology department of R.G. Kar Medical College & Hospital was to find out the socio-demographic correlates of self inflicted foreign body insertion in ear-nose-throat in children presenting in out patient department and emergency., Methods: A cross sectional descriptive study was conducted from October 2009 to March 2010 in the out patient department and emergency of otolaryngology. Using a predesigned and pretested questionnaire, socio-demographic data was collected prospectively on every alternate day by examining clinically all new pediatric patients attending with self-inflicted foreign body and interviewing their caregivers after removal of foreign body. The data collected from 288 children was analyzed by using simple proportion, odds ratio with 95% confidence interval, χ(2), t-test and analysis of one way variance (ANOVA) test. Epi info 3.4.3 version (CDC, Atlanta, retrieved from WHO website, on 01.11.09) and SPSS 17.0 were used for statistical calculations., Results: Analysis showed male preponderance (59.72%) of cases from urban area (63.9%), predominance of 0-5 years age group with 5.19 ± 3.02 (mean ± standard deviation) years average age, nasal foreign body was on the top (44.4%), majority from low income (58.33%) joint family (65.3%) with housewives (75.0%) as primary care giver, majority of whom reported to have nil or low literacy (61.1%). 19.4% subjects having local pathology showed significant association with urban residence, joint family, low socio-economic status and two or less than two children of the mother of the participant children. Past history of similar incidence was found in 22.2% of study subjects and significantly associated with nasal foreign body insertion and higher among the children of housewives., Conclusions: Increasing awareness of the prime caregivers by the routine grass root level health workers may be tried to reduce incidence of this risky health event and capacity building of the Primary level physicians to handle foreign body insertion cases can lessen the stress of the victim children and their parents., (Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.)

Introduction: Attention deficit hyperactivity disorder (ADHD) is one of the commonest behaviour disorders in children, characterized by hyperactivity, inattention and impulsiveness. Tendency towards risk-taking behaviour and accident proneness is well recognized in these children. Accordingly, it could be hypothesized that children with ADHD are at increased risk for self-inserting foreign bodies, but a Medline search did not reveal any studies that investigated this possibility., Objectives: To study the prevalence of ADHD among children seen with self-inserted foreign bodies., Method: Children attending ENT service in a tertiary care children's hospital with self-inserted foreign bodies were assessed for the presence of ADHD. Two rating scales, Strengths and Difficulties Questionnaire (SDQ)-Parent Version, and Conners Parent Rating Scale (CPRS) were used to identify the cardinal features of ADHD., Results: A total of 34 children, age 3-10 years, participated in the study. Majority (51.6%) were female. Nearly 25% had one or more previous incidents of foreign body insertion and 20% had previous accidental injuries that needed hospitalization. A prevalence of 14.3% for ADHD was identified, which is almost 3 times more than that reported in a previous study among children attending medical and surgical outpatient clinics (5.1%). High rates for abnormal hyperactivity scores were reported by parents, 37.4% with SDQ and 20% with CPRS. Although 64.7% of the sample was under 5 years, almost all children who were identified with ADHD belonged to 5-10 year age group, thus effectively excluding younger aged children who may have age related apparent hyperactivity., Conclusions: Awareness of possible association between self-insertion of foreign bodies and ADHD is needed and an assessment for hyperactivity/ADHD is justified in such children, especially in those over the age of 5 years.

Introduction: The objectives of this study were to: (i) evaluate the effectiveness of 'parent's kiss' as a technique for removal of nasal foreign bodies in children; and (ii) determine whether this technique reduces the number of children requiring general anaesthesia for their removal., Patients and Methods: This was a prospective observational study in the accident and emergency and ENT departments at Luton and Dunstable Hospital. The participants were 31 children with nasal foreign bodies, under the age of 5 years, presenting via the acute services over a 6-month period. The primary outcome measured was successful removal of nasal foreign body with the 'parent's kiss' technique. Secondary outcome was reduction in the number of general anaesthetics following introduction of the technique., Results: The technique was successful in 20 out of the 31 children (64.5%) in the study group. Only one patient required general anaesthesia for removal of nasal foreign body (3%). This compares with a rate of 32.5% requiring removal under general anaesthetic in the preceding 6-month period. The 'parent's kiss', when not successful, seemed to improve the visibility of the foreign body making their subsequent removal easier., Conclusions: The 'parent's kiss' is an effective technique. It is non-traumatic, both physically and emotionally, for the child subjected to it. We advocate that it should be used routinely as a first line of management in children with a nasal foreign body in the primary care setting.

Introduction: The occurrence of foreign bodies (FB) in otorhinolaryngological practice is a common and serious problem among pediatric patients. The aim of this work is to characterize the risk of complications and prolonged hospitalization due to FBs in the nose in terms of the characteristics of the injured patients (age, gender), typology and features of the FBs, the circumstances of the accident and the hospitalization's details., Materials and Methods: A retrospective study of FB associated injuries, assessing the characteristics of the injured child and the FB, the circumstances of the accident and finally the hospitalization details took place on children aged 0-14 in major hospitals of 19 European countries., Results: In total 688 cases were assessed. Complications and hospitalization occurred in 59 and 52 cases, respectively. Over 51% of patients were females. The median age of children who experienced a complication was four years. In the majority of cases FB removal was accomplished by means of a non-invasive technique (rhinoscopy with a nasal speculum or rigid fiberoptic endoscope. The majority of children were directly referred to the ENT department. The most common FBs associated with complications and hospitalization were nuts, seeds, berries, corn and beans, batteries and other inorganic objects such as broken parts of pens, paper clips and pearls. Over 38% of the injuries occurred under adults' supervision., Discussion: FB injuries in the nose are commonly encountered in clinical practice. Even if the presence of a FB is not usually life threatening, it may result in long-term complications such as perforation of the septum. Because the risks associated with FB injuries, public education about this problem is recommended.

Nasal foreign bodies represent a common ENT problem in children. Ninety percent of these can be removed without otorhinolaryngologic intervention. Numerous documented techniques exist, employing instruments, which pose problems in children. Positive pressure technique avoids the need for instrumentation, therefore bypassing the disadvantages met by other techniques. Positive pressure technique is both safe and effective, highlighted by a success rate of 62.5% in 8 patients presenting acutely. Promising result of this small study warrantees further study in larger number of paediatric population. In contrast to previous documentation, children nursed prone tolerated the procedure better. Hollow objects were resilient to this technique and require other methods of removal. Positive pressure technique should be considered to remove foreign bodies from the paediatric nose especially in emergency department setting.

Foreign bodies in the ear, nose, and throat are occasionally seen in family medicine, usually in children. The most common foreign bodies are food, plastic toys, and small household items. Diagnosis is often delayed because the causative event is usually unobserved, the symptoms are nonspecific, and patients often are misdiagnosed initially. Most ear and nose foreign bodies can be removed by a skilled physician in the office with minimal risk of complications. Common removal methods include use of forceps, water irrigation, and suction catheter. Pharyngeal or tracheal foreign bodies are medical emergencies requiring surgical consultation. Radiography results are often normal. Flexible or rigid endoscopy usually is required to confirm the diagnosis and to remove the foreign body. Physicians need to have a high index of suspicion for foreign bodies in children with unexplained upper airway symptoms. It is important to understand the anatomy and the indications for subspecialist referral. The evidence is inadequate to make strong recommendations for specific removal techniques.

Paediatric nasal foreign bodies is a common clinical problem effecting children mainly 2-8 years of age. Often treated in A & E Departments, with little or no specialised ENT experience or equipment. We present a simple, parent administered technique for removal of paediatric nasal foreign bodies. The technique is safe and effective and is easy to perform on nervous and frightened children.

Foreign body in the nose most frequently occurs in childhood. It could be of various origin, pieces of toys, paper and uncommon metal body. Consequences include one- sided nasal breathing problem, nasal secretion and in some cases pain and secretion become purulent. The aim of this paper is to present uncommon foreign body in the nose. RTG diagnosis and extraction are the methods of choice.