Lekshmi, R (2022) A Cross Sectional study on Upper Aerodigestive Tract Foreign Bodies in a Tertiary Care Center in Chennai. Masters thesis, Madras Medical College, Chennai.
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Abstract
INTRODUCTION: A foreign body is any object that is not normal to the place where it is found. Even though foreign body in the aero digestive tract is a common accident, it has potential for grave consequences, constituting an important cause of morbidity and mortality. The term foreign body entered medical language in the middle of 18th century. The number of texts on this increased rapidly till 1880, followed by another peak around 1918. In the late 19th and early 20th century, Chevalier Jackson dedicated his works to develop methods for safe removal of foreign bodies using the newly available oesophagoscope and bronchoscope. We are forever indebted to Dr Jackson and to those who have carried on his legacy such as Dr Sylvan Stool for the development of techniques for safe extraction of foreign bodies and, more importantly, for continued advocation of product safety regulation to reduce the overall threat to children in the home. AIMS AND OBJECTIVES 1. To estimate the prevalence of upper aero digestive tract foreign bodies. 2. To identify the common sites and types of presentation of various foreign bodies. 3. To analyse correlation between foreign bodies and associated complications. MATERIALS AND METHODS: STUDY PLACE: Upgraded Institute of Otorhinolaryngology, Rajiv Gandhi Government General Hospital and Institute of Child Health, Chennai - 600 003. STUDY DESIGN: Cross sectional study. STUDY PERIOD: July 2021 to December 2021. SAMPLE SIZE: 80 cases. INCLUSION CRITERIA: 1. Patients of all age groups with history of foreign body ingestion or aspiration. 2. Patients with complications of foreign body even without a history. EXCLUSION CRITERIA: 1. Patients not willing for study. 110 patients with history of foreign body ingestion or aspiration or with history of complications suggestive of foreign body who came to the Upgraded institute of otorhinolaryngology, Rajiv Gandhi Government General Hospital and Institute of child health, Chennai from July 2021 to December 2021are included in the study. The patients will be evaluated based on a detailed history and thorough clinical examination. Presence of foreign body and its location were confirmed using radiographs and endoscopy in selected cases were the physical examination was inconclusive. After confirmation, foreign bodies were removed either under local anesthesia or general anesthesia using an appropriate method. Post-operative x-rays were taken for confirmation. Patients were observed for any complications. CONCLUSION: • In this study, foreign bodies were more common in children than in adults. In females and males foreign bodies have almost equal incidence. • In children, both airway and digestive tract foreign bodies are found to have equal incidence. Among this nasal foreign bodies were exclusively seen in children. In adults, digestive tract foreign bodies were found to be slightly more than tracheobronchial foreign bodies. • The most common age for any foreign body is in the 1st decade. • In children, trying to taste new compact objects out of curiosity and carelessness of the caretaker was the most common causative factor of foreign bodies. In adults, trachea-bronchial foreign bodies are mainly due to inadequate tracheostomy care which leads to aspiration of broken metal tracheostomy tube. • In the digestive tract, chicken bone was the most common foreign body in adults while coins are more common in children. Groundnut was the most common foreign body in the airway which was seen in both nasal cavity and bronchus. • Majority of patients with foreign body, present within 1 day and all of them had positive history. Late presentation was seen more commonly in adults and it was statistically significant. • Dysphagia was the most common symptoms in DTFBs. Nasal obstruction and nasal discharge were the common symptoms in nasal foreign bodies, while in TBFBs, dyspnea and cough were the common findings. Fever was seen in both TBFB and DTFB, but more significantly associated with TBFB. Correlation between these symptoms and site of foreign body was found to be statistically significant. • Not even a single case of undetected bronchial foreign body which presented as lower respiratory tract infection was encountered in our study. • Most common site of foreign body impaction is nasal cavity followed by bronchus in the airway, while cricopharynx is the most common site in digestive tract followed by esophagus and tonsillar fossa. • Rigid endoscopic removal remains the procedure of choice in removal of foreign body in the trachea, bronchus and oesophagus. • Retropharyngeal abscess was the most common complication encountered in digestive tract foreign bodies followed by esophageal perforation. Bronchopneumonia was the only complication seen in our study due to tracheobronchial foreign bodies. • Early diagnosis and extraction of foreign body is necessary to prevent complications. Thus a high degree of suspicion by the attending physician and public education is necessary for timely intervention and prevention of morbidity.
| Item Type: | Thesis (Masters) |
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| Additional Information: | 221914015 |
| Uncontrolled Keywords: | Upper Aerodigestive Tract, Foreign Bodies, Tertiary Care Center, Chennai. |
| Subjects: | MEDICAL > Otolaryngology > MEDICAL > Otolaryngology |
| Depositing User: | Subramani R |
| Date Deposited: | 22 Apr 2022 14:37 |
| Last Modified: | 17 Dec 2023 06:23 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/19372 |
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