The Role of CT Scan in Pediatric Airway Foreign Bodies

Abstract

Mei-Lan Wang,1,* Lu Hui Png,2,* Jing Ma,1 Ken Lin,1 Mei-hua Sun,1 Yi-Jun Chen,3 Xian-Chao Tang,4 Xian-Yun Bi,1 Ying-Qin Gao,1 Tie-Song Zhang1 1Department of Otolaryngology, Head and Neck Surgery, Kunming Children’s Hospital, Kunming, People’s Republic of China; 2Department of Otorhinolaryngology – Head and Neck Surgery, Singapore General Hospital, Singapore, Singapore; 3Department of Otolaryngology, Head and Neck Surgery, Kunming Children’s Hospital, Kunming Medical University, Kunming, People’s Republic of China; 4Department of Radiology, Kunming Children’s Hospital, Kunming, People’s Republic of China*These authors contributed equally to this workCorrespondence: Lu Hui Png; Tie-Song Zhang, Email [email protected]; [email protected]: We aim to determine the utility of CT scan as a method to accurately confirm pediatric airway foreign bodies (AFBs), the current gold standard of which is chest X-ray as the primary imaging modality in the investigation screening of AFBs with progression to microlaryngobronchoscopy.Methods: A retrospective cohort study of children diagnosed with suspected AFBs between July 2019 and June 2020 was conducted. The primary outcome of missed AFBs from radiologic investigations was recorded.Results: A total of 226 children with an average age of 1.94 years were included in this study. One hundred and two children were eventually admitted to the hospital for microlaryngobronchoscopy. A total of 89 cases were initially examined by chest X-ray with the diagnosis confirmed in 26 cases. The initial examination was chest CT scan in 105 cases, of which the diagnosis was confirmed in 46 cases. The initial examination was chest CT scan with airway reconstruction in 32 cases, and the diagnosis was confirmed in 17 cases. Patients with negative chest CT scan with airway reconstruction were observed to have resolution of symptoms with no further need for bronchoscopy.Conclusion: Chest CT scan with airway reconstruction had the highest rate of confirmed diagnosis of pediatric AFBs on initial scanning, followed by chest CT scan, and finally chest X-ray with fluoroscopy; there was no missed diagnosis in chest CT scan with airway reconstruction. Chest CT scan with airway reconstruction can accurately and quickly detect AFBs and reduce unnecessary bronchoscopy.Keywords: airway foreign body, chest X-ray, chest CT scan, airway reconstruction, microlaryngobronchoscopy

Keywords

• airway foreign body
• chest x-ray
• chest ct scan
• airway reconstruction
• microlaryngobronchoscopy