Management of airway foreign body using flexible bronchoscopy: Experience with 80 cases during 2011–2013

Abstract

Background: Foreign body aspiration (FBA) into the tracheobronchial tree is a serious problem necessitating prompt recognition and management. This study aimed to report our experience in airway foreign body removal by flexible bronchoscopy. Study design: Descriptive study. Methods: A total of 80 patients with FBA were included in the study. They were 61 pediatric cases and 19 adult cases. Sixty-four were females and 16 cases were males, their age ranged from 2 to 52 years. The clinical manifestations, radiological findings and bronchoscopic findings of the procedure were analyzed. Results: Among the patients, only 88.8% had a definite history of FBA. The most frequent symptom was paroxysmal cough (61.3%), followed by expectoration, fever or wheezing, hemoptysis and dyspnea. Chest X-ray showed radiopaque foreign body in 78.8% of the patients, normal chest radiology in 8.8% and right lower lobe consolidation in 6.3%. The most common location of FB was either right or left lower lobe bronchus (16, 20%). Sixty-two (77.5%) of FB inhalation were pins, followed by seeds in 6 patients (7.5%), and plastic toys in 5 patients (6.3%). The gestures that lead to FBA by the patients were during laughter in 28 cases (35%), chalking (26.2%), talking (15%) and sneezing (8.8%). In 9 patients (11.2%) the acts that lead to FBA were not identified by the patients. Conclusions: Flexible bronchoscopy is successful in retrieving airway foreign bodies (88.8%). With skilled personnel and perfect equipments, flexible bronchoscopy could be considered as the first choice for the removal of airway foreign body.

Keywords

• Flexible bronchoscopy
• Foreign body
• Tracheo-bronchial tree