COMPLICATIONS ASSOCIATED WITH 327 FOREIGN-BODIES OF THE PHARYNX, LARYNX, AND ESOPHAGUS

We intended to identify the types and incidence of complications assoc iated with foreign bodies (FBs) impacted in the upper aerodigestive tr act (UADT) and to ascertain factors predisposing to the development of these complications. The design was a retrospective cohort study of 3 27 patients with UADT foreign bodies admitted to a tertiary care cente r. The overall incidence (7.6%) and types of complications varied by a ge. Complications developed in 4.8% of 208 patients 10 years of age an d under, with pulmonary complications being most common. In contrast, complications occurred in 12.6% of 119 older patients, with retrophary ngeal abscess being the most common (p<.0001). Delayed presentation (> 24 hours after the onset of symptoms) was the only factor associated w ith an increase in the incidence of complications in the younger patie nts (p=.02). In contrast, pharyngeal location of the FB (p=.0004), the FB's being a fish bone (p=.006), and radiolucency (p=.02) were all as sociated with an increased incidence of complications in patients over 10 years of age. A significant risk for complications is present for patients admitted for the management of FBs in the UADT. Older patient s with sharp FBs are at greatest risk. In this group of patients, clos e observation in the perioperative period is required, especially if t here is evidence of mucosal injury.