RESEARCH ARTICLE


Different Modalities Used in the Art of Managing Tracheobronchial Foreign Bodies



Hanan M. Hemead1, *, Abdelmaguid Ramadan1, Alaa H. Gaafar2, Ayman Nossier1, Ahmed Abdelaziz1
1 Cardiothoracic Surgery, Department of Cardiothoracic Surgery, University of Alexandria, Alexandria, Egypt
2 Otorhinolaryngology, Department of Otorhinolaryngology, University of Alexandria, Alexandria, Egypt


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Creative Commons License
© 2022 Hemead et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Cardiothoracic Surgery, University of Alexandria, Egypt, Tel: +201273486192; E-mail: hana_hemead@yahoo.com


Abstract

Introduction:

Foreign body aspiration is a commonly encountered and challenging emergency. Foreign body aspiration causes significant morbidity and mortality in the paediatric population. In adults, it is usually encountered in patients with impaired consciousness and in young females using pins to secure their veils. We aimed to analyse the incidence, type and site of foreign body, radiological presentation, complications and different modalities used in managing tracheobronchial foreign bodies (FBs).

Methods:

A prospective single centre cross-sectional study between December 2010 and December 2011 in the Department of Cardiothoracic Surgery at the University of Alexandria, Egypt.

Results:

Seventy-eight patients were included. The age of the patients ranged between 1.3 and 32 years, with a mean of 13.37± 7.67 years. Inorganic FBs were the most common aspirated FBs (66 patients, 84.62%). FBs were more frequently located in the left versus the right bronchial tree (44.9% vs. 43.6%). Rigid bronchoscopic extraction of foreign bodies was the most common modality of extraction and was seen in 60 patients (76.9%), followed by thoracotomy and postural drainage in eight patients each (10.3%). Complications were observed in 12 patients (15.4%). Most of the patients who presented with pin aspiration were teenagers (> 10 – 20 years) and adults (> 20 years). At the same time, nut aspiration was common in children below 10 years.

Conclusion:

The location of FBs in the tracheobronchial tree depends on the patient's age and physical position at the time of aspiration. Rigid bronchoscopy offers better manipulations inside a secured airway and is the preferred method for foreign body removal. If failed, then surgical extraction should be done as soon as possible.

Keywords: Bronchoscopy, Bronchi, Airway obstruction, Foreign bodies, Trachea, Thoracotomy.