Pediatric Sharp Foreign Body Aspiration: Revealing Unexpected Risk Factors

Sunday, September 29, 2024

9:42 AM – 9:48 AM EDT

Location: MBCC, 225

Disclosure(s):

Alicia Belaiche, MS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Trevor A. Lewis, MDCM:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Liane B. Johnson, MDCM:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Trina C. Rosaasen, MD, MEd:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Sharp foreign body aspiration (FBA) is a serious condition with potentially fatal consequences. This 20-year multicenter study examines the demographic and clinical features of pediatric sharp FBA.

Methods: A retrospective chart review was conducted on patients aged 0-17 years who have had sharp FBs removed via rigid bronchoscopy below the vocal cords at the McGill University, McMaster University, and University of Alberta health centers in Canada. This study spanned from January 1st, 2000 to December 31st, 2020.

Results: In total, 49 patients (31 males and 18 females, mean age of 9.4 years) met the inclusion criteria. Thumbtacks were the most common aspirated objects (30/49 cases, 61.2%). The mean age for thumbtack aspiration was 11.6 years, which is significantly higher than the 6-year mean for other sharp FBAs (p = 0.0007). Subgroup analysis of patients who resided in an Indigenous territory or who were of Indigenous origin had a significantly greater rate of thumbtack aspiration (24/26 cases, p < 0.0001). The most common symptoms included cough (79.6%), choking (53.1%), and dyspnea (24.5%). Intraoperatively, 42.9% of patients showed mucosal injury, 14.3% exhibited granulation tissue, and 2% had mucosal perforation. In patients presenting with granulation tissue, the average interval from the onset of symptoms to assessment by ENT specialists was 23.72 hours. In contrast, patients without granulation tissue averaged 226 hours. The postoperative complications identified were atelectasis (22.4%), fever (6.1%), respiratory distress (4.1%), and pneumothorax (2%).

Conclusions: This is the largest pediatric study on sharp FBA in North America, addressing a significant gap in the literature. Considering the trends and patient demographics identified in this study and in the literature globally, geographical or cultural variations may influence the nature of sharp FBA in pediatric populations, a phenomenon specific to this category of FB. Insights from this study can inform future prevention programs.

Presenting Author(s)

Alicia Belaiche, MS

Medical Student
McGill University
Montreal, QC, Canada

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

TL

Trevor A. Lewis, MDCM

Staff Surgeon
McMaster University
Hamilton, Ontario, Canada

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
JP

Jakob TK Pugi, MD

Resident Physician
McMaster University
HAMILTON, ON, Canada

Disclosure information not submitted.
MB

Mariya Bogatchenko, MDCM, BSc

McMaster University, United States

Disclosure information not submitted.
Liane B. Johnson, MDCM

Associate Professor, Dalhousie University, Department of Surgery, Division of Paediatric Otolaryngology-HNS
IWK Health Centre
Halifax, Nova Scotia, Canada

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
TR

Trina C. Rosaasen, MD, MEd

Associate Professor / Surgeon
University of Alberta Hospital / Stollery
Edmonton, Alberta, Canada

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Senior Author(s)

LN

Lily Ha-Nam P. Nguyen, MDCM, MSc, MHPE

Associate Professor
McGill University
Montreal, Quebec, Canada

Disclosure information not submitted.