Abstract Introduction Foreign body accidents (FBAs) are frequent in children and can be severe, being a common cause of morbidity and mortality and a public health problem. As these accidents are multifactorial, their cause can only be determined by analyzing the clinical details and characteristics of the object. Knowing the associated mechanisms and factors is essential to determine a risk profile and have a preventive, therapeutic, and diagnostic purpose. Objective The present study aimed to describe the incidence of FBAs in otorhinolaryngology according to their anatomical location, focusing on the aerodigestive system. Methods This is a retrospective study performed by reviewing the medical records of 668 cases seen in the emergency department of a tertiary pediatric hospital in São Paulo, state of São Paulo, Brazil, between 2014 and 2017. Results Foreign bodies (FBs) were found in the digestive system (238/668), in the nasal cavities (206/668), in the ears (182/668), in the oropharynx (34/668), and in the respiratory system (8/668). A total of 91.77% of the patients were treated in the emergency room. The main age group affected was < 5 years old, with no difference between genders. The most frequent complications affected the digestive system and the most serious occurred in cases involving the respiratory system. Conclusion Multidisciplinary teams should be ready in the emergency room to provide adequate care in FBAs. Early diagnosis, FB removal in the emergency room or the surgical center and follow-up are essential. Developing prevention campaigns including a risk profile for certain products and/or materials, helping to ensure safety for consumers, is necessary. For this, a national database with compulsory notification containing relevant information on FBAs in the pediatric population should be created.

A injeção intracordal de gordura tem sido utilizada para medializar a prega vocal em casos de paralisia laríngea, com resultados variáveis. A ausência de consenso entre os autores em relação a diversos aspectos técnicos, como o local de injeção, pode contribuir, em parte, para essa variação. OBJETIVO: Estudar o efeito do local de injeção em relação à distribuição espacial da gordura dentro da prega vocal e à configuração glótica após essas injeções. FORMA DE ESTUDO: Experimental. MATERIAL E MÉTODO: Seis laringes adultas excisadas foram utilizadas. Gordura colhida por lipoaspiração foi injetada, por meio de uma seringa de pressão, no ponto médio da prega vocal em três laringes e lateralmente ao processo vocal da aritenóide em outras três. Fotografias digitais em vista cranial da glote foram obtidas antes e após as injeções. Após fixação e descalcificação, as laringes foram cortadas no plano frontal nos terços anterior, médio e posterior da prega vocal e no nível da cartilagem aritenóide, para estudar a distribuição da gordura. RESULTADOS: Somente a injeção de gordura lateralmente ao processo vocal da aritenóide permitiu o fechamento da glote posterior. A gordura tendeu a ocupar um espaço cilíndrico dentro do músculo tireoaritenóideo, ao longo do maior eixo da prega vocal, mesmo quando injetada próximo ao processo vocal. CONCLUSÕES: O local de injeção da gordura teve influência sobre a configuração glótica após a injeção, apesar da gordura tender a ocupar um espaço cilíndrico ao longo da prega vocal em ambos os grupos.

Intracordal fat injection has been used for vocal fold medialization in cases of laryngeal paralysis with variable results. A lack of consensus among the authors concerning various technical aspects, such as the site of injection, may contribute, in part, to this variation. AIM: To study the effects of the place of fat injection on the spatial distribution of fat and the configuration of the glottis after the injections. STUDY DESIGN: Experimental. MATERIAL AND METHOD: Six adult excised larynges were used. Fat harvested by liposuction was injected with a high-pressure syringe in the middle point of the vocal fold in three larynges and lateral to the vocal process of the arytenoid in another three. Digital photographs from a cranial view of the glottis were obtained before and after the injections. After fixation and decalcification, the larynges were cut in the frontal plane at the anterior, middle and posterior thirds of the vocal fold and at the level of the arytenoid cartilage in order to study the distribution of fat. RESULTS: Closure of the posterior glottis was observed only when fat was injected lateral to the vocal process of the arytenoid. Fat tended to occupy a cylindrical space inside the thyroarytenoid muscle, along the longer axis of the vocal fold, even when injected close to the vocal process of the arytenoid. CONCLUSION: The place of fat injection influenced the configuration of the glottis after injection, although the fat tended to occupy a cylindrical space along the longer axis of the vocal fold in both groups.

Introdução e objetivos: Este trabalho tem como objetivos estudar o comportamento da criança ao ser submetida a videonasofaringolaringoscopia - e a eficiência da rotina adotada pelos autores para sua realização - e descrever a rotina do exame, contribuindo para sua melhor execução por outros profissionais da área médica. Forma do estudo: Prospectivo clínico randomizado. Material e Método: O presente estudo foi realizado com 105 crianças e adolescentes, cuja faixa etária variou de 1 a 15 anos, sendo a média de 7,3 anos, submetidos a endoscopia nasal e/ou faringolaríngea com endoscópio flexível. Resultados: O índice de sucesso do procedimento foi de 99,04% - em apenas uma das crianças foi impossível a execução da endoscopia. A ocorrência de náusea não impediu a boa avaliação da laringe, estando presente em apenas 6,7% dos casos. O choro ocorreu em alguma das fases da rotina de exame em 24,76% do total de pacientes: em 42,10% das crianças de 0 a 5 anos (Grupo I); em 20,93% das de 6 a 10 anos (Grupo II); e em 0,00% dos adolescentes de 11 a 15 anos (Grupo III). A cavidade nasal foi a região mais relacionada com tal ocorrência, correspondendo a 80% dos casos que choraram durante o exame. Conclusão: Ao findarmos a pesquisa, concluímos que a videonasofaringolaringoscopia flexível é muito eficiente segundo a rotina adotada e que a tolerância do paciente mostrou-se proporcional a sua idade.

Introduction and objectives: The purpose of the present study was to report the children’s behaviour during the accomplishment of the videonasopharyngolaringoscopy and the efficiency of the routine adopted by the authors for its execution. In addition, we describe our routine that leads the best execution in the pediatric population. Study design: Prospective clinical randomized. Material and Method: The study was accomplished in 105 children and adolescents, whose mean age was 7,3 years (range, 1-15 years) who underwent nasal endoscopy and or pharyngolaryngoscopy with flexible endoscope. Results: It was impossible to perform the exam in only one child (success rate- 99,04%). The occurrence of nausea did not preclude a good evaluation of the larynx and it was present in 6,7% of the cases. Among the patients enrolled in the study 24,76% of the children cried in some phases of the exam. During the endoscopic examination 42,10% of the children whose age ranged from 0 to 5 years (group I); 20,93% of the patients between 6 and 10 years (group II) and 0,00% of the patients between 11 and 15 years (group III) cried. The nasal cavity was the area more related to its occurrence, corresponding to 80% of the children that cried during the examination. Conclusion: In conclusion, using the routine adopted by the authors, the flexible nasopharyngolaryngoscopy is a very efficient method and the patient’s tolerance is proportional to his age.