{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T05:34:25Z","timestamp":1763098465825,"version":"3.45.0"},"reference-count":37,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,2,18]],"date-time":"2025-02-18T00:00:00Z","timestamp":1739836800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To examine the safety and efficacy of a step\u2010by\u2010step protocol for the office removal of aural foreign bodies (FB) in a pediatric population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All children presenting to an academic pediatric outpatient department were identified from a computerized collection of office notes and operative reports. FB removal was performed in a standard fashion including: (1) pre\u2010procedure discussion with shared decision making, (2) restraint in a supine position with a trained second person holding the head, (3) FB removal using an operative microscope and instrumentation. A case was considered a failure if subsequent removal under sedation or general anesthesia was required.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      447 total cases (ears) were identified in 428 children (19 had bilateral FBs). 201\/428 (47%) of children had previous attempts at FB removal elsewhere. 431\/447 (96.4%) of FBs were successfully extracted in the office. 16\/447 (3.6%) of FBs were removed in the operating room. Out of the 431 successful removals, two patients had minor complications (ear canal lacerations). No child suffered a more severe complication. The failed removal group was more likely to have a documented neurodevelopmental disorder (4\/21 vs. 12\/407,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This protocol resulted in a high rate of successful FB removal, even in children with prior failed attempts. There were no significant ear injuries in this 22\u2010year experience, which included children with attention\u2010deficit\/hyperactivity disorder (ADHD) and autism spectrum disorder. This approach should be considered by otolaryngologists who care for children in the office setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>3\u2014Retrospective review.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.32073","type":"journal-article","created":{"date-parts":[[2025,2,18]],"date-time":"2025-02-18T04:23:51Z","timestamp":1739852631000},"page":"2625-2630","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Safety and Efficacy of a Protocol for In\u2010Office Pediatric Aural Foreign Body Removal"],"prefix":"10.1002","volume":"135","author":[{"given":"Dilan","family":"Prasad","sequence":"first","affiliation":[{"name":"Departments of Otolaryngology\u2010Head &amp; Neck Surgery, and Pediatrics Lewis Katz School of Medicine at Temple University  Philadelphia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5977-1796","authenticated-orcid":false,"given":"Glenn","family":"Isaacson","sequence":"additional","affiliation":[{"name":"Departments of Otolaryngology\u2010Head &amp; 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