Foreign body in the ear, nose and throat: retrieval under general anaesthesia.

Abstract

Background: Foreign body (FB) in the ear, nose or throat is a common emergency in otolaryngology practice. Majority of cases are managed by awake procedures in the clinic setting. Surgical removal under general anaesthesia is commonly used for foreign body in aero-digestive tracts and may be indicated for foreign body in other regions when patient fails to cooperate for awake removal, especially where complications have set in from previous failed attempts at removal. Aim: To audit the indications, route of anaesthesia, outcome and challenges of retrieval of foreign body in the ear, nose and throat under general anaesthesia in our practice. Methodology: We conducted a retrospective review of all cases of foreign body retrieved under general anaesthesia with the aim of auditing the indication, location of FB, route of anaesthesia and outcome of surgical management. Result: A total of 109 patients had foreign body removal under general anaesthesia. The most common foreign body were toys of various shapes and sizes in 29(26.0%) cases. Foreign bodies in the oesophagus 65(59.6%) constituted the most common indication for retrieval under general anaesthesia, while FB in the larynx 3(2.8%) was the least common location. All the 23(21.1%) patient with FB in the external auditory canal (EAC) presented with complications from pre-hospital failed attempts at removal. Post-operative ICU admission rate was 1.9%, while mortality rate was 0.95%. Conclusion: Retrieval of foreign bodies in the ear, nose and throat under general anaesthesia is not without risks, though the benefits outweigh the risk. Surgeons should be mindful of the remote risk of surgical and anaesthetic complications and even mortality.