Extraction of Aural Foreign Bodies in a Rural Setting: 10-Year Review and a Novel Method to Remove Magnetic Stones.

BACKGROUND: The external auditory canal's unique anatomical characteristics made the presence of foreign bodies (FBs) a clinical challenge, particularly in rural settings without ready access to tertiary care and specialist intervention. AIMS: Our study surveys the experience in aural FBs surgical management in a rural Australian tertiary center. It proposes a safe, easy, and affordable technique to remove stones from the ear canal. METHODS: We have completed a 10-year retrospective surgical chart review, including 474 patients (52 adults and 428 children) requiring surgical management to remove aural FBs at the Royal Darwin Hospital, Northern Territory, Australia. We surveyed for patient demographics, foreign-body description, complications, location, and removal attempts. We identified what factors determine the need for surgical management and propose a technique for a safe, uncomplicated, and affordable removal of stones from the ear canal after applying this method in a small subgroup. RESULTS: The most common FBs requiring surgery in children were stones. A predominance in the Aboriginal population from remote communities was found, leading to a nasal bridle magnet technique to remove stones in rural settings. This method reduces the number of extraction attempts of the most frequent FB found in children's ears, aiming to minimize complications, negative experiences, and health cost. CONCLUSION: Contrary to international literature, stones were found to be the most common FB in remote aboriginal populations. The proposed technique reduces the number of extraction attempts of the most frequent FB found in children's ears, aiming to minimize complications, negative experiences, and health cost.

Sleep quality and obstructive sleep apnoea in Indigenous and non-Indigenous Australian children.

BACKGROUND: Literature pertaining to the prevalence of obstructive sleep apnoea (OSA) and sleep quality among Indigenous Australian children is sparse. This study assessed various sleep related parameters and outcomes between Indigenous and non-Indigenous Australian children. METHODS: Children referred to the sleep health service in the Northern Territory of Australia for a clinically suspected sleep disorder between 2015 and 2021 were included in this study. Self-reported sleep measures alongside polysomnography data were assessed and compared between these two diverse ethnic population. RESULTS: Of the 671 sleep studies assessed, 121 (18%) were from Indigenous children. The majority of patients were male (61%), with a median age of 5.7 (3.5, 8.9) years, and body mass index (BMI) in the normal range (57%). Indigenous children were significantly older (median 7.2 years (4.5, 11.9), with a higher BMI (p = 0.005) and a greater proportion living in very remote locality (14% vs. 6% non-Indigenous, p = 0.001). Indigenous children had higher Paediatric Daytime Sleepiness Scale scores (p = 0.001), higher screen use before bed (p = 0.005), later bedtimes (p = 0.001) and reduced total sleep time (p = 0.034) compared to non-Indigenous children. Prevalence of OSA was higher in Indigenous children (55% vs. 48%) and with greater severity compared to non-Indigenous children. CONCLUSIONS: In this study, OSA was more prevalent and more severe in Indigenous children than their non-Indigenous peers. However, this may not necessarily be extrapolated to the general Indigenous paediatric population. Sleep hygiene and sleep quantity was also decreased further impacting adequate sleep. This highlights the importance of identifying and managing these addressable parameters and for targeted interventions.