{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T07:38:52Z","timestamp":1763105932377,"version":"3.40.4"},"reference-count":12,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Pediatr Emer Care"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:sec>\n            <jats:title>Objectives<\/jats:title>\n            <jats:p>To determine the effect of developmental delay (DD) and autism spectrum disorder (ASD) on pediatric external auditory canal foreign body (EAC FB) retrieval outcomes.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>A retrospective chart review of children presenting with EAC FB at a tertiary children's hospital was performed between January 2018 and December 2019. Charts were reviewed for demographics, presence of otalgia, complications, number of EAC FB episodes, indications for operating room removal, DD, and ASD status.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>A total of 1467 patients underwent EAC FB removal. One hundred thirty-seven children (9.3%) had DD, and, of those with DD, 63 (46%) had ASD. Children with DD were 1.76 years older compared with children with non-DD (NDD) (<jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.0001) at the time of presentation, whereas children with ASD were 1.45 years older than children with NDD (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.0023). Children with DD and ASD were more likely to require removal of FB in the operating room (OR) compared with the NDD group (36.5% vs 16.7%, <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.0001). This was not true for children with DD without ASD. Patients with DD reported significantly less otalgia when compared with NDD patients (26.3% vs 37.4%, <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.0097). A similar trend, although not statistically significant, was observed when comparing children with ASD with NDD patients. The NDD patients (1.1) had fewer EAC FB episodes than patients with DD (1.6, <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.0001) and ASD (1.8, <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.0016). Hazard ratios for multiple episodes of FB were 4.5 (95% confidence interval, 2.9\u20136.8) for DD, and 5.6 for ASD (95% confidence interval, 3.2\u20139.9). The complication rate for all groups was low.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Due to the different ways that children with DD and ASD present compared with NDD children, physicians should be vigilant when evaluating symptoms and conducting physical examinations for EAC FB in those patients. A lower threshold for referral to otolaryngologists may result in more favorable outcomes.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/pec.0000000000002960","type":"journal-article","created":{"date-parts":[[2023,5,10]],"date-time":"2023-05-10T23:48:18Z","timestamp":1683762498000},"page":"408-412","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["The Effect of Developmental Delay and Autism Spectrum Disorder on External Auditory Canal Foreign Body Extraction"],"prefix":"10.1097","volume":"39","author":[{"given":"Justin D.","family":"Nguyen","sequence":"first","affiliation":[{"name":"Baylor College of Medicine, Houston, TX"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael C.","family":"Shih","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shaun A.","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi-Chun Carol","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shraddha S.","family":"Mukerji","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"bib1-20250504","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1097\/00006565-198706000-00001","article-title":"Foreign bodies of the ears and nose in childhood","volume":"3","year":"1987","journal-title":"Pediatr Emerg Care"},{"key":"bib2-20250504","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/S0165-5876(98)00118-9","article-title":"Ear and nose foreign body removal in children","volume":"46","year":"1998","journal-title":"Int J Pediatr Otorhinolaryngol"},{"key":"bib3-20250504","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1111\/j.1742-6723.2006.00865.x","article-title":"Presentation and management of aural foreign bodies in two Australian emergency departments","volume":"18","year":"2006","journal-title":"Emerg Med Australas"},{"key":"bib4-20250504","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1016\/j.emc.2012.09.003","article-title":"Critical procedures in pediatric emergency medicine","volume":"31","year":"2013","journal-title":"Emerg Med Clin North Am"},{"key":"bib5-20250504","doi-asserted-by":"crossref","first-page":"109871","DOI":"10.1016\/j.ijporl.2020.109871","article-title":"The aural foreign body space: a review of pediatric ear foreign bodies and a management paradigm","volume":"132","year":"2020","journal-title":"Int J Pediatr Otorhinolaryngol"},{"key":"bib7-20250504","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1016\/S0140-6736(18)31129-2","article-title":"Autism spectrum disorder","volume":"392","year":"2018","journal-title":"Lancet"},{"key":"bib8-20250504","doi-asserted-by":"crossref","first-page":"e20190811","DOI":"10.1542\/peds.2019-0811","article-title":"Prevalence and trends of developmental disabilities among children in the United States: 2009\u20132017","volume":"144","year":"2019","journal-title":"Pediatrics"},{"key":"bib9-20250504","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1097\/00129492-200207000-00014","article-title":"Emergency department management of foreign bodies of the external ear canal in children","volume":"23","year":"2002","journal-title":"Otol Neurotol"},{"key":"bib10-20250504","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/S0385-8146(85)80014-6","article-title":"Iatrogenic ossicular injury in an autistic child","volume":"12","year":"1985","journal-title":"Auris Nasus Larynx"},{"key":"bib11-20250504","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1016\/j.ijporl.2019.01.006","article-title":"Aural and nasal foreign bodies in children - 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