A study of patients presenting with foreign bodies in the ear and Aerodigestive tracts in the department of otorhinolaryngology of Muhimbili national hospital

Abstract

Foreign bodies' accident in Otorhinolaryngology is an important reason for seeking emergency services. Objective: To evaluate the incidence of patients with foreign bodies, to analyze the types, sites, the commonest presentations, average duration before presentation and complications related to delayed presentation. Method: The prospective study was realized in 113 patients with a diagnosis of foreign bodies of the nose, ear, pharynx, oesophagus and tracheabronchial tree in the Otorhinolaryngology service of the Muhimbili National Hospital in Dar es Salaam between marchl2007 and september/2007. Results: The overall incidence of foreign bodies in the aerodigestive tracts and the ear was 2.46% of all the patients attended at the Otorhinolaryngology service during the study period (113/4600). It was 2.54% in male (59/2324), and 2.37% in female (54/2276). The highest foreign bodies incidence was 6.56% in the age group between 0 to 4years (7411129).Among these 43(38.05%) cases of foreign bodies in the nose, 28 (24.78%) cases in the ear and 18 (15.93%) cases in the pharynx, 16(14. 16%)cases in the oesophagus and 8(7.08%) cases in the tracheabronchial tree. Of these patients, 52.21% were male and 47.79% were female. Two-year-old were the most common patients, and the range from age 0 to age 4 included 65.48% of all the patients. 50.44% of these cases were taken care of in less than 24 hours and 25.66% more than 72hours. The most common symptoms of the foreign bodies was; odynophagia which present in 66.67% of the cases of the pharynx; unilateral purulent rhinorrhea which was present in 69.77% of the nose, pain which was present in 96.43% cases of ear; dysphagia which was present in 62.5% cases of oesophagus and difficult in breathing which was present in 100% cases of tracheabronchial-tree The most frequent foreign bodies were coin (61.11 %) in the pharynx; bean seed (39.53%) in the nose; beads (25%) in the ear; and groundnut seed and metallic object 25% each in the tracheabronchial -tree. Complications which resulted from delayed presentation were found in 20 cases (17.7%). Conclusion: Young children were the most affected age group Coin was the most common oesophagus and pharyngeal foreign bodies. Seeds and beads were commonest foreign bodies in the nose, tracheabronchial-tree and the ear respectively. Foreign bodies in the aerodigestive tracts tended to present early and were more promptly removed compared with ear and nose foreign bodies. Most cases of foreign bodies which presented early had no complications; however those who presented late were associated with complications in particular those in the tracheabronchial-tree. This emphasizes the need to educate caretaker on taking care of the children and presenting them promptly to a health facility in the event of foreign bodies accidents. Since most of the foreign bodies' accidents are preventable health education to the public should be emphasized