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Investigative strategies for fish bone foreign bodies during the coronavirus disease 2019 pandemic: an analysis of ENT UK guidelines

Part of: JLO Coronavirus Collection

Published online by Cambridge University Press:  26 February 2021

J Michaels ,
C Orji ,
F Green  and
C Nogueira
J Michaels*
Affiliation:
ENT Department, Royal London Hospital, London, UK
C Orji
Affiliation:
ENT Department, Royal London Hospital, London, UK
F Green
Affiliation:
ENT Department, Royal London Hospital, London, UK
C Nogueira
Affiliation:
ENT Department, Royal London Hospital, London, UK
*
Author for correspondence: Dr Joshua Michaels, ENT Department, Royal London Hospital, Whitechapel Road, LondonE1 1FR, UK Email: [email protected]
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Abstract

Background

By nature of their specialty, otolaryngologists are disproportionately exposed to coronavirus disease 2019 through aerosol-generating procedures and close proximity to the oropharynx during examination.

Methods

Our single-centre, retrospective study analysed the pertinence of guidelines produced by ENT UK to improve the investigation and management of suspected upper aerodigestive fish bone foreign bodies during the coronavirus disease 2019 pandemic.

Results

Our results demonstrated 43.3 per cent (n = 13) low-risk cases and 56.7 per cent (n = 17) moderate-risk cases. Nine fish bones (two low risk, seven moderate risk) were found; none of these were confirmed with X-ray and three (moderate risk) required nasoendoscopy for diagnosis. One patient required rigid pharyngoscopy.

Conclusion

This study confirms that soft tissue neck X-ray and flexible nasoendoscopy are unnecessary in low-risk cases; however, early nasoendoscopy in higher suspicion cases is appropriate. Recommendations are made about the long-term sustainability of these guidelines, and additional measures are encouraged that relate to repeat attendances and varying prevalence of coronavirus disease 2019 in the hospital catchment area.

Keywords

COVID-19OtolaryngologyForeign BodiesDiagnostic Imaging
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 135 , Issue 3 , March 2021 , pp. 250 - 254
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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Footnotes

Dr J Michaels takes responsibility for the integrity of the content of the paper

References

Kim, HU. Oroesophageal fish bone foreign body. Clin Endosc 2016;49:318–26CrossRefGoogle ScholarPubMed
Arulanandam, S, Das De, S, Kanagalingam, J. A prospective study of epidemiological risk factors for ingestion of fish bones in Singapore. Singapore Med J 2015;56:329–32CrossRefGoogle Scholar
Meccariello, G, Gallo, O. What ENT doctors should know about COVID-19 contagion risks. Head Neck 2020;42:248–9CrossRefGoogle ScholarPubMed
ENT UK. COVID-19 - Adult Nasoendoscopy (FNE) and Possible Upper Aerodigestive Tract Fish Bone Investigation. In: https://www.entuk.org/covid-19-adult-nasoendoscopy-fne-and-possible-upper-aerodigestive-tract-fish-bone-investigation-0 [19 February 2020]Google Scholar
Sanei-Moghaddam, A, Sanei-Moghaddam, A, Kahrobaei, S. Lateral soft tissue X-ray for patients with suspected fishbone in oropharynx, a thing in the past. Iran J Otorhinolaryngol 2015;83:459–62Google Scholar
Lue, AJ, Fang, WD, Manolidis, S. Use of plain radiography and computed tomography to identify fish bone foreign bodies. Otolaryngol Head Neck Surg 2000;123:435–8CrossRefGoogle ScholarPubMed
Karnwal, A, Ho, EC, Hall, A, Molony, N. Lateral soft-tissue neck X-rays: are they useful in management of upper aero-digestive tract foreign bodies? J Laryngol Otol 2008;8:845–7CrossRefGoogle Scholar
Curran, J, Calder, N, Yaneza, M, Iyer, A. Reducing potential aerosol generation in flexible nasolaryngoscopy: a novel method. J Laryngol Otol 2020;134:744–6CrossRefGoogle ScholarPubMed