title: Upper aerodigestive magnetic foreign bodies in children.
abstract: OBJECTIVE
  Small, powerful magnets are increasingly available in toys and other products, and are responsible for increasing numbers of foreign body injuries in children. Small, spherical, neodymium magnets available since 2008 are of particular concern. We aimed to identify all cases of upper aerodigestive foreign bodies at our institution over 15.5 years of study.
  
  
  METHODS
  Case series including all patients treated at an urban, tertiary care children's hospital who had upper aerodigestive magnetic foreign bodies, from January 1, 1998 through April 30, 2013.
  
  
  METHODS
  We manually reviewed 7,049 patient records abstracted from billing data to identify all patients 0 to 20 years of age who had upper aerodigestive magnetic foreign bodies.
  
  
  RESULTS
  We identified four cases of upper aerodigestive magnetic foreign bodies, one involving the hypopharynx, and three involving the upper esophagus. Three occurred in 2010 or later. Two cases involve the ingestion of multiple, spherical, neodymium magnets recently marketed as desktop toys. In both of these cases, there was a rapid development of mucosal injury at the site of attraction between two magnets.
  
  
  CONCLUSIONS
  As small, powerful magnets become more ubiquitous, pediatric magnet foreign body injuries are increasing. Although most are gastrointestinal, we identified four recent cases involving the upper aerodigestive tract. Multiple magnets lodged in the hypopharynx or esophagus can rapidly cause pressure necrosis of mucosal tissues, and merit prompt management. Education regarding magnet safety and improved magnet safety standards are needed to reduce the risk of these injuries.
  
  
  METHODS
  4.
authors.affiliation: Seattle Children's Hospital, Seattle, Washington; Department of Pediatrics, Division of Emergency Medicine, University of Washington, Seattle, Washington, U.S.A.
authors.forename: Julie C
authors.initials: JC
authors.lastname: Brown
authors.forename: Fred M
authors.initials: FM
authors.lastname: Baik
authors.forename: Henry C
authors.initials: HC
authors.lastname: Ou
authors.forename: Jeffrey P
authors.initials: JP
authors.lastname: Otjen
authors.forename: Hannah G
authors.initials: HG
authors.lastname: Parish
authors.forename: Dylan K
authors.initials: DK
authors.lastname: Chan
mesh_terms: D002675:Child, Preschool; D016208:Databases, Factual; D003679:Deglutition; D004825:Epiglottis; D004945:Esophagoscopy / Q000379:methods; D004947:Esophagus; D005260:Female; D005500:Follow-Up Studies; D005547:Foreign Bodies / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000628:therapy*; D006786:Hospitals, Urban; D006801:Humans; D007013:Hypopharynx; D015994:Incidence; D007223:Infant; D007828:Laryngoscopy / Q000379:methods; D059346:Magnets; D008297:Male; D011859:Radiography; D012189:Retrospective Studies; D018570:Risk Assessment; D012494:Sampling Studies; D062606:Tertiary Care Centers; D016896:Treatment Outcome
keywords: Esophageal; aerodigestive; airway; children; foreign body/foreign bodies; magnet(s); vallecula