Pediatric hard palate foreign bodies: Case report and Systematic review of the literature

Introduction: Foreign body impaction in the pediatric hard palate is a rarely described otolaryngologic entity. It is often misdiagnosed as a neoplastic or an inflammatory lesion causing much stress to parents. The aim of this paper is to report a case managed in our department and to present a systematic review of the literature on pediatric hard palate foreign body impaction. Case report: We present the case and the management of an impacted plastic screw cap in the hard palate of a 9 month-old boy. Material and methods: Following the PRISMA guidelines, a systematic review was conducted in August 2019 using Medline and Embase databases. Included articles were reviewed for mean age at presentation, gender, presumptive diagnosis, time to removal, foreign body type, average size, anesthesia type and complications. Results: 32 reported cases were included. Foreign bodies were mistaken for other diagnoses in 24 cases. Mean duration from first presentation till removal was 56.9 days. Circular plastic covers were found in 20 cases. General anesthesia was used in 68% of the cases. No major complications were reported. Conclusions: Foreign body impaction should be kept in the differential diagnosis of hard palate lesions in children. Up to date, this entity is still frequently misdiagnosed.