SRS330 - Reducing unnecessary procedures: a review of examination of ears under anaesthesia in children where no foreign body was found

Abstract Foreign body insertion into the ear is a frequent cause for paediatric emergency presentations. When removal in the clinic is unsuccessful, children are often referred for removal under general anaesthesia. However, a subset of these procedures reveals no foreign body, exposing patients to unnecessary anaesthetic risk and adding pressure to healthcare services. This retrospective study reviewed paediatric patients (aged 2–17 years) who underwent ear foreign body removal procedures over a three-year period. The primary objectives were to determine the rate of unnecessary procedures (no foreign body detected), analyse patient demographics, and assess complication rates. A total of 66 patients were identified. Of these, 58 (87.9%) had a confirmed foreign body, while 8 (12.1%) had none. Among patients without a foreign body, 25% had autism spectrum disorder, compared with 19% in the confirmed foreign body group. No major complications were recorded. The findings suggest that children with autism may be at greater risk of unnecessary procedures, potentially due to communication difficulties, behavioural patterns, and diagnostic uncertainty. This study highlights the importance of refining diagnostic pathways to reduce avoidable interventions. Recommendations include developing enhanced diagnostic protocols tailored for autistic children, providing targeted training for clinicians, and increasing caregiver education to improve reporting accuracy. Further research is warranted to better understand the association between autism and suspected foreign body insertion. Optimizing diagnostic accuracy can enhance patient safety, reduce unnecessary exposure to general anaesthesia, and improve resource allocation within the NHS.