Periinterventionelle Aspekte bei Body-Piercing im Kopf-Hals-Bereich

Background: Since the last decade of the past century body modification in the shape of body piercing has gone to a worldwide mass phenomenon of youth culture in western societies. These practices originate in millennia-old traditions of tribal societies all over the world. According to definition body piercing describes the transcutaneous puncturing of a body part in order to create an opening in which jewelry can be worn. However, there are also various implications for health involved in the trend of body piercing. In the past numerous studies have analysed epidemiological aspects as well as the medical repercussions of the trend. Pain, swelling, inflammation, allergic reaction and bleeding rate among the common medical complications. But also long-term injuries such as formation of scar tissue and persistent deformity are described in literature. Today the majority of the procedures are performed in specialised piercing parlours, however there is still a problem of non-licensed commercial practice in many countries without sufficient quality standards. In the clinical routine the ENT physician is inevitably faced with the medical consequences arising from body piercing especially considering the head and neck area being the most common site for this purpose. The aim of this dissertation is to gain information about the current practice of body piercing on the basis of a local unrepresentative sample. Methods: Data collection was conducted retrospectively by a 12-item questionnaire containing information regarding personal data as well as periinterventional aspects. Inclusion criterion consisted in current or former presence of at least one body piercing in the head and neck area. Participants were recruited among the staff of the Städtisches Klinikum Solingen, the patients treated in the ENT department and their accompanying persons. Data were collected within a time period of approximately 2 years (february 2015 to may 2017). Data analysis was performed descriptively. By application of a multivariate logistic regression model the asocciation between probability of a complication and other variables was determined. Significance level was stated at p< 0.05. Results: Overall, 405 completed questionnaires containing 799 documented piercings were included in data evaluation. Female participants accounted for 89.5% (N=715) of the body modifications, 10.5% (N=84) of the piercings were attributed to the male subjects. On average, the majority of piercings was performed in women at an age between 14 - 20 years. Male participants received their body modifications averagely at a slightly higher age. With a proportion of 38.5% of all documented piercings, the outer ear represented the most popular anatomical site. The most common individual location was determined to be the Ala nasi (21.5%). Furthermore, the piercing of the tongue (13.6%) as well as the labret piercing (12.4%) were counted among the most frequently documented piercing sites. The vast majority of procedures was carried out in piercing parlours (74.3%), the most commonly used instrument represented the hollow needle (88.9%). The overall satisfaction was evaluated „very good“ by the majority of participants. The highest ratings were received by the physicians who performed piercing procedures. Over all, complications were reported in 27.7%, the most frequent health problems were pain, swelling and local inflammation. Most of the complications occurred among the piercing jewellers (41.5%). Outstandingly complicated were the anatomical sites of the ear cartilage, the earlobe as well as the tongue. Compared with the tongue piercing, the eyebrow (p=0.033) and labret piercing (p=0.040) were associated with a significantly lower risk of complication. Tendencies towards risk reduction were shown for interventions conducted by a physician (p=0.110), for recommended behavioural measures (p=0.127) and advice of disinfection (p=0.110). Outpatient medical treatment was conducted in 5.0% of the cases, 4.1% of the reported complications resulted in hospital admission. Conclusion: The study describes various aspects concerning the practice of body piercing in the head and neck area. It has been pointed out that these procedures are associated with numerous hazards for health, which may be traced back to problematic periinterventional settings. Therefore a differentiated approach to the topic is of great importance for the clinician particularly with regard to the objective of improving the safety of body piercing.