Management of Wire Brush Bristle Ingestion: Review of Literature and Presentation of an Algorithm.

OBJECTIVES: To increase awareness of wire brush bristle ingestion, review the literature relating to wire brush bristle ingestion, and describe an algorithm for management of wire brush bristle foreign bodies as well as a technique for bedside removal. METHODS: The authors present a case of an accidental wire bristle ingestion that was successfully treated with bedside removal and describe a successful bedside technique for removal. For the literature review, the PubMed journal database and Google Scholar were queried using the search terms wire bristle, wire brush, grill brush, and grill bristle. RESULTS: Twenty-three wire brush ingestions with upper aerodigestive presentations were identified in the medical literature. Bedside visualization was attempted in 10 patients and successful in 5. The foreign body was able to be removed at the bedside in 3 of these patients. Two patients were managed conservatively. The authors developed an algorithm for management based on these literature findings. CONCLUSION: Wire brush bristle ingestion is increasingly common in the literature, and a definitive algorithm does not exist for management. The authors present an algorithm for management and describe a technique for successful removal at the bedside.

Hazards and Management of Wire Bristle ingestions: A Systematic Review.

OBJECTIVE: Inadvertently ingested grill brush bristles can lodge in various locations and lead to a variety of injuries. They can also be difficult to identify and remove. Our primary objective was to perform a systematic review of cases reported in the literature, with analysis of trends in clinical presentation and success of diagnostic modalities and treatment approaches. DATA SOURCES: Cases of reported grill brush bristle ingestion reported in PubMed, PubMed Central, and Google Scholar databases through April 30, 2021. REVIEW METHODS: Databases were searched for the following terms: ("ingestion" OR "injury" OR "barbeque" OR "BBQ" OR "grill" OR "foreign body" OR "brush" AND "wire" OR "bristle"). Data were collected on patient demographics, clinical presentation, and treatment course. Statistical analysis was performed on characteristics with low risk of confounding. RESULTS: An overall 57 studies involving 91 patients were included. Grill brush bristles presented most commonly in the upper aerodigestive tract (48/91), followed by the abdomen (26/91) and deep neck (17/91). Computed tomography was the most accurate imaging modality for initial diagnosis, identifying 92.8% of bristles. Less invasive or adjunctive techniques such as endoscopy, intraoperative imaging, or minimally invasive surgery may be useful particularly for bristles located in the head and neck given the low rate of success of transoral surgery (66.7%). CONCLUSION: Although this review of retained bristle may be biased toward complex cases, retained grill brush bristles represent an underrecognized and difficult-to-manage hazard. When cases are suspected, clinicians should obtain computed tomography imaging based on presentation and tailor management appropriately.

Intraoperative Ultrasound for Localization and Removal of an Oropharyngeal Wire Grill-Brush Bristle.

OBJECTIVES: This paper reports the utilization of intraoperative ultrasound in the removal of an accidentally ingested wire grill-brush bristle from the pharyngeal space of a child. METHODS: Standard procedures for obtaining imaging of an accidentally ingested foreign body were performed, including radiograph, computed tomography (CT) imaging, and preoperative ultrasonography. Despite preoperative imaging, the object could neither be located nor removed. Ultrasonography was performed intraoperatively for real-time localization. RESULTS: Intraoperative ultrasonography was required to successfully locate and remove the wire grill-brush bristle from the patient's oropharyngeal space. CONCLUSIONS: Intraoperative ultrasound serves as a useful tool to guide surgical removal of aerodigestive foreign bodies and may offer an opportunity to reduce the need for CT imaging.

At-a-glance - Sentinel surveillance of emergency department presentations for barbecue brush-related injuries: the electronic Canadian Hospitals Injury Reporting and Prevention Program, 2011 to 2017. / Aperçu - Surveillance par sentinelle des blessures associées aux brosses à barbecue traitées dans des services d'urgence : la plate-forme électronique du Système canadien hospitalier d'information et de recherche en prévention des traumatismes, 2011-2017.

A barbecue (BBQ) brush is a common household item designed for cleaning grills used for barbecuing. Data from the electronic Canadian Hospitals Injury Reporting and Prevention Program database were analysed to estimate the frequency of injuries related to BBQ brushes as a proportion of all injuries, as well as to describe characteristics associated with such injury events. Between April 1, 2011 and July 17, 2017, BBQ brush injuries were observed at a frequency of 1.5 cases per 100 000 eCHIRPP cases (N = 12). Findings suggest that in addition to risks associated with the ingestion of loose BBQ brush bristles attached to foods, loose bristles could also result in injury via other mechanisms.

RÉSUMÉ: Une brosse à barbecue (BBQ) est un article de ménage très courant destiné à nettoyer les grilles de BBQ. Les données de la base de données de la plate-forme électronique du Système canadien hospitalier d'information et de recherche en prévention des traumatismes (eSCHIRPT) ont été analysées afin d'estimer la fréquence des blessures associées aux brosses à BBQ par rapport à l'ensemble des blessures, ainsi que de décrire les caractéristiques associées à ces accidents. Entre le 1er avril 2011 et le 17 juillet 2017, on a observé des blessures associées aux brosses à une fréquence de 1,5 cas par 100 000 cas dans l'eSCHIRPT (N = 12). Les résultats indiquent qu'outre les risques associés à l'ingestion de poils tombés de la brosse à BBQ et attachés aux aliments, ces poils pourraient aussi causer des blessures par d'autres mécanismes.

Epidemiology of Wire-Bristle Grill Brush Injury in the United States, 2002-2014.

OBJECTIVES: The purpose of this study was to investigate the epidemiology of wire-bristle grill brush injury. STUDY DESIGN AND SETTING: Cross-sectional analysis of national databases; literature review. SUBJECTS AND METHODS: The Consumer Product Safety Commission's National Electronic Injury Surveillance System (NEISS) was used to derive a national weighted estimate of emergency department visits for wire bristle injury from 2002 to 2014. Date, location of injury, demographics, and outcomes were analyzed. A literature search and a consumer-reported injury database (SaferProducts.gov) were interrogated to provide ancillary sources of data. RESULTS: A total of 43 cases were found within the NEISS database, which extrapolated to an estimated 1698 (95% confidence interval, 1468-1927) emergency department visits nationwide. In the NEISS database, the mean age was 30 years, and the sex distribution of the patients was similar (21 males vs 22 females). The most common location of injury was the oropharynx in both the NEISS database (23 of 43, 53.4%) and the literature review (11 of 36, 30.5%). However, the oral cavity was the most frequent site in the consumer-reported SaferProducts.gov database (9 of 24, 37.5%). The majority of patients in the NEISS were treated in the emergency department (31 of 43, 69.7%). Raw case counts were highest in June, July, and August, with the highest number of events in the month of July. CONCLUSION: Injury from wire-bristle grill brush is uncommon but prevalent during certain seasons. Otolaryngologists play an important in the diagnosis and treatment of these injuries. Awareness among consumers and product manufacturers is necessary to promote safety.