The Management of Aural Foreign Bodies During the COVID-19 Pandemic -
Our Experience in 39 Patients
Abstract
Aim: During the initial wave of the COVID-19 pandemic, ENT UK published
a clinical guide on surgical prioritisation which suggested that aural
foreign bodies can be removed between one and three months from initial
presentation. This case series aims to investigate the impact of leaving
aural foreign bodies in situ for a prolonged period of time, including
the risk of complications, success rates of subsequent removal attempts
and whether foreign bodies can clear themselves without intervention.
Method: Retrospective study of all aural foreign body referrals to the
ENT emergency clinic over a 6-month period. Results: Thirty-four
patients were identified. The duration of foreign bodies left in-situ
ranged from 1 to 78 days. Four patients suffered from traumatic removal
upon initial attempts, however there were no other significant
complications. First attempts made by non-ENT specialists (68.8%) all
failed and were associated with a high risk of trauma (36.4%). The
chances of successful removal on second attempt (28.6%) reduced
dramatically when compared to the first attempt (52.9%). Two patients
had no foreign body visualised upon second attempt, suggesting it has
cleared itself. A total of 7 patients (20.6%) required removal under
general anaesthesia. Conclusions: Due to the unique circumstances of the
COVID-19 pandemic, this is the first case series to look specifically at
the relationship between duration of aural foreign bodies left in situ
for over 30 days from presentation and the risk of complications. Our
data suggests that prolonged duration did not increase the incidence of
complications.