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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

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