Clinical Features and Complications of External Auditory Canal Foreign Bodies in the ENT Emergency Unit.

Kuan-Ting Yeh, Chih-Yu Hu, Bang-Yan Zhang, Kai-Chieh Chan
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Abstract

Objective: To determine the risk factor for developing complications in patients undergoing removal procedures for foreign bodies (FBs) in the external auditory canal (EAC) in the otolaryngology (ENT) emergency unit. Methods: Cases involving patients with EAC FBs treated at the ENT emergency unit of a tertiary medical center were retrospectively recruited. Patients were classified into the age < 10 years and ≥10 years groups. Univariate analyses of the complication rates were performed in all patients and the two age groups. Results: The mean age of the 457 patients was 29.9 ± 19.9 (range, 1.0-89.0) years; 42.7% (n = 195) were under 10 years of age, and 57.1% (n = 261) were male. Complications following FB removal occurred in 40 cases (8.8%), with EAC laceration being the most common (4.4%). Patients under 10 years of age had a higher risk of developing complications than those over 10 years (13.8% vs 5.0%, P = .001), with the younger group also showing an increased risk of EAC laceration (6.7% vs 2.7%, P = .039). Conclusion: Patients under 10 years of age had a significantly-higher rate of complications after EAC FB removal in the ENT emergency unit. Sedation or surgical removal under general anesthesia should be considered to minimize the risk of complications after a failed removal under direct vision in this patient group. Further studies are warranted to verify this implication for clinical practice.

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耳鼻喉科急诊室外耳道异物的临床特征和并发症。
目的确定在耳鼻喉科急诊室接受外耳道异物(FB)取出手术的患者出现并发症的风险因素。方法:回顾性收集在一家三级医疗中心耳鼻喉科急诊室接受治疗的外耳道异物患者病例。将患者分为年龄小于 10 岁组(<10 岁)和年龄大于 10 岁组(≥10 岁)。对所有患者和两个年龄组的并发症发生率进行单变量分析。结果显示457 名患者的平均年龄为 29.9 ± 19.9(1.0-89.0)岁;42.7%(n = 195)的患者年龄小于 10 岁,57.1%(n = 261)的患者为男性。切除 FB 后发生并发症的有 40 例(8.8%),其中以 EAC 裂伤最为常见(4.4%)。与 10 岁以上的患者相比,10 岁以下的患者发生并发症的风险更高(13.8% 对 5.0%,P = .001),年轻患者发生 EAC 裂伤的风险也更高(6.7% 对 2.7%,P = .039)。结论:在耳鼻喉科急诊室,10 岁以下患者切除 EAC FB 后的并发症发生率明显更高。应考虑在全身麻醉下进行镇静或手术切除,以最大限度地降低这类患者在直视下切除失败后出现并发症的风险。有必要进行进一步研究,以验证其对临床实践的意义。
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