ABSTRACT
Background: Aspiration of an open safety pin in the airway is an extremely rare and critical condition that needs immediate and safe removal of the foreign body (FB). An open safety pin in the airway of the pediatric patient requires urgent recognition. Imaging will confirm the exact site of the open safety pin in the airway. Rigid bronchoscopy with optical forceps or grasping forceps is an ideal tool for the removal of the open safety pin from the airway. Objective: This study aims to evaluate the clinical details, management, and outcome of pediatric patients with an inhaled open safety pin in the laryngotracheal airway. Materials and Methods: This is a retrospective descriptive study done between November 2016 and December 2021. There were six children with inhaled open safety pins in the laryngotracheal airway. The diagnosis was done through proper history taking, clinical examination, and the X-ray of the neck and chest of the children. All children underwent rigid bronchoscopy with optical forceps to remove the open safety pin. Results: Out of the six children, four were boys and two were girls. Out of the six cases, four were in the proximal part of the airway and two were seen in the distal airway. The most common clinical presentation was coughing. In this study, open safety pins of the pediatric airway were removed successfully under general anesthesia with the help of a rigid bronchoscope. Conclusion: Open safety pin is rarely found in the laryngotracheal airway. Open safety pin may cause a life- threatening complication. During the removal of the open safety pin, the surgeon should maintain maximum care to not injure the surrounding structures by the sharp end of the open safety pin.
ABSTRACT
Background: Antrochoanal polyps (ACPs) are benign polypoidal mass originating from the maxillary sinus and they extend into the choana. The etiopathogenesis of ACP is not clear. These are found more commonly in children and young adults. ACP is almost always unilateral and common symptoms include nasal obstruction and nasal discharge. These lesions are extremely rare in the older adult age group. Materials and Methods: This is a retrospective study of 14 cases of ACPs managed between June 2017 and July 2022. Detailed clinical presentations, investigations, and treatment with surgical interventions for ACPs were studied. Results: Out of 14 cases of older adult patients with ACPs, there are 8 (57.14%) cases with a polyp on the left side and 6 (42.85%) cases on the right side of the nasal cavity. The most common symptom was constant and unilateral nasal obstruction in 12 (85.71%) patients, followed by purulent nasal discharge in 7 (50%) cases, clear rhinorrhea in 5 (35.71%) cases, facial pain in 4 (28.57%) cases, snoring in 3 (21.42%) cases, sneezing in 3 (21.42%) cases, and halitosis in 2 (14.28%) cases. Conclusion: ACPs are uncommon in the older adult age group. Diagnostic nasal endoscopy and computed tomography scans are important tools for the diagnosis of ACP. Functional endoscopic sinus surgery and power instrumentation are helpful for the complete removal of ACPs and are considered extremely safe procedures. Clinicians and otolaryngologists are often not aware of the prevalence of ACPs among the older adult age group.