DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20160059

Airway foreign bodies: our six years’ experience with 301 cases

Jayalaxmi S. Aihole, Narendra Babu M., Deepak J., Vinay Jadhav

Abstract


Background: Foreign body aspiration (FBA) is a common problem in children and accounts for an important cause of morbidity and mortality. The main objective of this study was to evaluate the clinico-demographic profile and management of foreign body (FB) aspiration in hospitalized patients.

Methods: This was a retrospective study conducted at Indira Gandhi institute of child health, Bangalore during the period from January to December 2015. All patients who gave a history of FBA or suspected of FB aspiration, those who had recurrent chest infection and who had undergone bronchoscopy were included in the study. Medical records were used for data collection of cases recurrent chest infections. The diagnosis of FBA was made from the documented clinical presentations, physical findings and investigations like chest X ray, CT scan whenever done. The management included rigid bronchoscopy and surgical interventions like tracheotomy, thoracotomy with bronchotomy and thoracoscopic retrieval.

Results: Most of the patients were in the age group between 1 to 3 years 206 (68%). Males were more affected 217 (72%) than females 84 (27.9%). 290 patients (96.3%) presented early (within 7 days of aspiration) with cough and respiratory distress. FBs were found impacted in the right bronchial tree more commonly, 195 (82.2%), followed by left bronchial tree in 30 (12.6%) and in the trachea 8 (3.3%) cases. In failed bronchoscopy cases, other surgical modalities like tracheotomy, laryngotomy, bronchotomy, thoracoscopic retrieval were attempted.

Conclusions: Children of the age group 1-3 years were found most vulnerable for FB aspiration. FBs were mostly vegetative and were found mostly in the right bronchial tree. Removal of FB by rigid bronchoscopy was safe and effective when patients presented early. Surgical modalities of management like tracheotomy, laryngotomy, bronchotomy were needed in cases of late presentation.


Keywords


Airway, Foreign body, Tracheo bronchial intervention

Full Text:

PDF

References


Zhu F, Sun M, He F. Clinical analysis of tracheobronchial foreign bodies in children in 1276 cases. Lin Chuang Er Bi Yan Hou Ke Za Zhi 2006;20:699-701.

Banerjee A, Rao SKSVK, Khanna SK, Narayanan PS, Gupta BK, Sekar JC. Laryogo-tracheo bronchial foreign bodies in children. J Laryngol Otol 1988;102(11):1029-32.

Zerella JT, Dimler M, Mcgill LC. Foreign body aspiration in children : Value of Radiography and Complications of Bronchoscopy. J Pediatr Surg. 1998;33:1651-4.

Black RE, Johnson G, Matlak ME. Bronchoscopic removal of aspirated foreign bodies in children. J Pediatr Surg. 1994;29:682-4.

Mu L, Sun D, Pe H. Radiological diagnosis of aspirated foreign bodies in children. A review of 343 cases. J Laryngol Otol. 1990;104:778 -2.

Vane DEW, Pritchard J, Coville CW, West KW, Eigen H, Grosfeld JL. Bronchoscopy for aspirated foreign bodies in children. Arch Surg. 1988;123(7):885-8.

Lakhkar BB, Kini P, Shenoy V, Bhaskaranand N. Foreign body aspiration: Manipal experience. Indian Pediatr. 2000;37:193-5.

Soaji R, Ramachandra CD, Cruz A. Subcutaneous Emphysema : an unusual presentation of foreign body in the airway. J Pediatr Surg. 1995;30:860-2.

Johnson DG, Condon VR. Foreign bodies in the paeditric patient. Current problems in Surgery.1998; 35:275-379.

Debeljak A, Sorli J, Music E, Kecelj P. Bronchoscopic removal of foreign bodies in adults: experience with 62 patients from 1974-1998. Eur Respir J. 1999;14:792-5.

Aytaç A, Yurdakul Y, Ikizler C, Olga R, Saylam A. Inhalation of foreign bodies in children. Report of 500 cases. J Thorac Cardiovasc Surg. 1977;74(1):145-51.

Soysal O, Kuzucu A, Ulutas H. Tracheobronchial foreign body aspiration: a continuing challenge. Otolaryngol Head Neck Surg. 2006;135:223-6.

McGuirt WF, Holmes KD, Feehs R, Browne JD. Tracheobronchial foreign bodies. Laryngoscope 1988;98:615-8.

Mu L, He P, Sun D. Inhalation of foreign bodies in Chinese children: a review of 400 cases. Laryngoscope. 1991;101:657-60.

Fitzpatrick PC, Guarisco JL. Pediatric airway foreign bodies. J La State Med Soc. 1998;150:138-41.

Metrangelo S, Monetti C, Meneghini L, Zadra N, Giusti F. Eight years’ experience with foreign-body aspiration in children: What is really important for a timely diagnosis? J Pediatr Surg. 1999;34:1229-31.

Mallick SM, Khan RA, Al-Bassam A. Late presentation of tracheobronchial foreign body aspiration in children. J Trop Pediatr. 2005;51:145-8.

Inglis AF Jr. Wagner DV. Lower complication rates associated with bronchial foreign bodies over the last 20 years. Ann Otol Rhinol Laryngol.1992;101(1):61-6.

Elhassani NB. Tracheobronchial foreign bodies in the Middle East. J Thorac Cardiovasc Surg. 1988;96(4):621-5.

Hamden AL, Mroueh SM, Bitar FF. Foreign body retrieval in children with respiratory symptoms and no history of aspiration Middle East. J Anaesthesiology.2000;215(6):673-80.

Aihole JS, Babu MN.Spontaneous migration of Foreign body to tract Gastrointestinal. Indian paediatric. 2015;52(6):534-5.

Cohen, SR, Herbert WI, Lewis GB Jr, Geller KA. Foreign bodies in the airway - 5 year retrospective study with special reference to management. Ann Otol Rhinol Laryngol. 1980;89(5 Pt 1):437-42.

Steen KH, Zimmerman T. Tracheobronchial aspiration foreign bodies in children - a study of 94 cases. Laryngocope. 1999;100(5):525-30.