{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T06:36:12Z","timestamp":1777876572768,"version":"3.51.4"},"reference-count":10,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2025,3,13]],"date-time":"2025-03-13T00:00:00Z","timestamp":1741824000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neonatal-Perinatal Medicine"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:p>A significant number of pediatric patients require a nasogastric tube (NGT) during their hospital stay for indications including nutrition support, medication delivery and decompression of the gastrointestinal tract. As such NGT placement is commonly performed; however, misplacement can occur into other anatomic sites within proximity.<\/jats:p>\n                  <jats:sec>\n                    <jats:title>Primary Diagnosis<\/jats:title>\n                    <jats:p>We report a first in the literature case of NGT misplacement into the middle ear via the eustachian tube in a one-week-old premature infant that required an NGT for feeding support.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Findings<\/jats:title>\n                    <jats:p>There was no reported resistance or concerns during NGT insertion; however, blood was noted in the syringe during aspiration performed to confirm tube position. A plain film radiograph and thereafter high-resolution computed tomography (HRCT) imagining confirmed the malposition of the tube within the middle ear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions and Outcomes<\/jats:title>\n                    <jats:p>After transfer to a tertiary center, the NGT was removed without event in the neonatal intensive care unit (NICU) under direct vision with a flexible nasal endoscopy and successful replacement occurred thereafter. No injury to the middle ear structures or hearing occurred.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Practice Recommendations<\/jats:title>\n                    <jats:p>While not a common site of misplacement, nasogastric tubes can be misdirected via the eustachian tube into the middle ear. Imaging modalities such as plain film radiographs and computed tomography can be helpful when misplacement is suspected based on bedside assessment. Protocols for routine replacement of functional nasogastric tubes after specific time periods in an effort to prevent nasal alar or nasal cavity complications from pressure should consider the risk of misplacement and consequences thereof.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19345798251327369","type":"journal-article","created":{"date-parts":[[2025,3,14]],"date-time":"2025-03-14T02:17:41Z","timestamp":1741918661000},"page":"282-284","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Malposition of a nasogastric tube into the middle ear of a premature one week old infant"],"prefix":"10.1177","volume":"18","author":[{"given":"Abeer","family":"Alali","sequence":"first","affiliation":[{"name":"Department of Otolaryngology-Head &amp; Neck Surgery, Adan Hospital, Ministry of Health, Hadiya, Kuwait"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharon","family":"Cushing","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head &amp; Neck Surgery and Archie\u2019s Cochlear Implant Laboratory, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adrian","family":"James","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head &amp; Neck Surgery and Archie\u2019s Cochlear Implant Laboratory, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Krista","family":"Marcotte","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Health Science North, Sudbury, ON, Canada,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5851-8166","authenticated-orcid":false,"given":"Noah","family":"Ditkofsky","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging, Toronto East Health Network Michael Garron Hospital, Toronto, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,3,13]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2011.04.001"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0090-3019(99)00077-4"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1726-4901(08)70141-2"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1308\/003588412X13171221502347"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.4103\/0259-1162.128931"},{"key":"e_1_3_3_7_2","first-page":"891","article-title":"Retropharyngeal infected hematoma: a unique complication of nasogastric tube insertion","volume":"67","author":"Hirshoren N","year":"2009","unstructured":"Hirshoren N, Gross M, Weinberger JM, et al. Retropharyngeal infected hematoma: a unique complication of nasogastric tube insertion. J Trauma 2009; 67: 891.","journal-title":"J Trauma"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/00130478-200210000-00011"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0929-6646(09)60113-3"},{"key":"e_1_3_3_10_2","first-page":"147","article-title":"Unusual complication of nasogastric esophageal intubation-erosion into an aberrant right subclavian artery","volume":"18","author":"Merchant FJ","year":"1977","unstructured":"Merchant FJ, Nichols RL, Bombeck CT. Unusual complication of nasogastric esophageal intubation-erosion into an aberrant right subclavian artery. J Cardiovasc Surg 1977; 18: 147\u2013150.","journal-title":"J Cardiovasc Surg"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199807000-00031"}],"container-title":["Journal of Neonatal-Perinatal Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/19345798251327369","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/19345798251327369","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/19345798251327369","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T22:26:50Z","timestamp":1777588010000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/19345798251327369"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,13]]},"references-count":10,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,5]]}},"alternative-id":["10.1177\/19345798251327369"],"URL":"https:\/\/doi.org\/10.1177\/19345798251327369","relation":{},"ISSN":["1934-5798","1878-4429"],"issn-type":[{"value":"1934-5798","type":"print"},{"value":"1878-4429","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,13]]}}}