Laryngeal and Tracheobronchial Foreign Body - Bronchoscopic Removal with Telescopic Guidance

Abstract

Introduction:

Foreign body aspiration is a challenging experience for otolaryngologists the world over especially in the pediatric age group. Presentation could be within few hours to years depending on the type, size, location and the presenting symptom of the foreign body. The major issue involves the accurate diagnosis, speedy and safe removal, thus the method of removal is therefore of importance. This study evaluates the value of bronchoscopy with telescopic guidance in tracheobronchial foreign body removal in Bingham University Teaching Hospital Jos.

Methods:

A retrospective review of patients who had bronchoscopy for suspected foreign bodies in the larynx/ tracheobronchial-tree, attending or referred to BHUTH over a 5 year period - June 2010 to June 2015. Records were retrieved and analyzed for age, type of FB aspirated, time of presentation, etc and the method of removal (i.e. bronchoscopy under telescopic guidance).

Results

58 patients aged 1 to 16 years were seen with 39 males and 19 females, m:f ratio of 2.05:1. Commonest age group less than 5 years (n=36) 62%, most common site of lodgment is the right main bronchus in 42 cases (72.4%). Commonest foreign bodies were organic (peanuts, seeds and other food particles) 44(75.9%), however inorganic FB (plastic and metallic materials - toys, ear rings, pins) 14(24.1%) were seen with longer duration at presentation. Removal was by bronchoscopy under telescopic guidance. No mortality, but morbidity in the form of pneumonia in six cases and cardiac arrest in one case which was successfully resuscitated.

Conclusion and Recommendations:

Telescopic guided removal was more accurate and with less complications. Since accurate diagnosis of FB aspiration is challenging, suspected cases of TFB aspiration should always have explorative bronchoscopy.

Key Words: Laryngeal, Tracheobronchial, Foreign Body, Bronchoscopy, Telescopic guidance.