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Endoscopic Foreign Body Removal

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Interventions in Pulmonary Medicine

Abstract

Aspiration of a tracheobronchial foreign body (TFB) is a fairly common emergency occurring more frequently in children than adults. In 2001, an estimated 17,537 children aged ≤14 years were treated in emergency departments for choking-related episodes. One hundred and sixty of these children died due to airway obstruction. A missed or delayed diagnosis of a TFB can cause additional respiratory problems including chronic wheezing that may mimic asthma, chronic cough, and recurrent pneumonia. A delay in diagnosis can also result in airway edema and granulation tissue around the TFB creating difficulty in extraction.

Bronchoscopy is a safe procedure allowing full inspection of the airway and visualization of the degree of TFB obstruction. Traditionally, the rigid bronchoscope has been the equipment of choice in the extraction of TFB due to a wide variety of instruments and control of the airway. More recent experience and advances in flexible bronchoscopy instruments, however, have shown that TFB can be safely and successfully removed with flexible bronchoscopy. A team approach to the extraction with anticipation of potential problems and solutions is essential for success. Surgical removal is rarely necessary.

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References

  1. Gotsch K, Annest J, Holmgreen P, et al. Nonfatal choking-related episodes among children - United States, 2001. Morb Mortal Wkly Rep. 2002;51:945–8.

    Google Scholar 

  2. VonEiken C. The clinical application of the method of direct examination of the respiratory passes and the upper alimentary tract. Arch Laryngol Rhinol. 1904;15.

    Google Scholar 

  3. Clerf L. Historical aspects of foreign bodies in the air and food passages. Ann Otol Rhinol Laryngol. 1952; 61:5–17.

    PubMed  CAS  Google Scholar 

  4. Jackson C. The technique of insertion of intratracheal insufflation tubes. Surg Gynecol Obstet. 1913;17: 507–9.

    Google Scholar 

  5. Greenland K, Eley V, Edwards M, et al. The origins of the sniffing position and the three axes alignment theory for direct laryngoscopy. Anaesth Intensive Care. 2008;36:23–7.

    PubMed  Google Scholar 

  6. Jackson C. Position of the patient for peroral endoscopy. Peroral endoscopy and laryngeal surgery. St Louis: The Laryngoscope; 1915.

    Google Scholar 

  7. Friedberg S, Bluestone C. Foreign body accidents involving the air and food passages in children. Otolaryngol Clin North Am. 1970;3:395–403.

    PubMed  CAS  Google Scholar 

  8. Baharloo F, Veyckemans F, Francis C, et al. Tracheobronchial foreign bodies: presentation and management in children and adults. Chest. 1999;115: 1357–62.

    Article  PubMed  CAS  Google Scholar 

  9. Oguzkaya F, Akcali Y, Kahraman C, et al. Tracheobronchial foreign body aspirations in childhood: a 10-year experience. Eur J Cardiothorac Surg. 1998;14:388–92.

    Article  PubMed  CAS  Google Scholar 

  10. Limper AH, Prakash UB. Tracheobronchial foreign bodies in adults. Ann Intern Med. 1990;112:604–9.

    PubMed  CAS  Google Scholar 

  11. Burton EM, Brick WG, Hall JD, et al. Tracheobronchial foreign body aspiration in children. South Med J. 1996;89:195–8.

    Article  PubMed  CAS  Google Scholar 

  12. Metrangolo S, Monetti C, Meneghini L. Eight-year’s experience with foreign body aspiration in children: what is really important for a timely diagnosis? J Pediatr Surg. 1999;34:1229–31.

    Article  Google Scholar 

  13. Silva AB, Muntz HR, Clary R. Utility of conventional radiography in the diagnosis and management of pediatric airway foreign bodies. Ann Otol Rhinol Laryngol. 1998;107:834–8.

    PubMed  CAS  Google Scholar 

  14. Hitter A, Hullo E, Durand C, et al. Diagnostic value of various investigations in children with suspected foreign body aspiration. Eur Ann Otorhinolaryngol Head Neck Dis. 2011;128:248–52.

    Article  PubMed  CAS  Google Scholar 

  15. Cevizci N, Dokucu A, Baskin D. Virtual bronchoscopy as a dynamic modality in the diagnosis and treatment of suspected foreign body aspiration. Eur J Pediatr Surg. 2008;18:398–401.

    Article  PubMed  CAS  Google Scholar 

  16. Haliloglu M, Ciftci A, Oto A. CT virtual bronchoscopy in the evaluation of children with suspected foreign body aspiration. Eur J Radiol. 2003;48:188–92.

    Article  PubMed  Google Scholar 

  17. Hughes CA, Baroody FM, Marsh BR. Pediatric tracheobronchial foreign bodies: historical review from the Johns Hopkins Hospital. Ann Otol Rhinol Laryngol. 1996;105:555–61.

    PubMed  CAS  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  19. Law R. Non-asphyxiating tracheobronchial foreign bodies in adults. Eur Respir J. 1994;7:510–4.

    Article  Google Scholar 

  20. Rodriguez H, Passali G, Gregori D, et al. Management of foreign bodies in the airway and esophagus. Int J Pediatr Otorhinolaryngol. 2012;76 Suppl 1:S84–91.

    Article  PubMed  Google Scholar 

  21. Martinot A, Closset M, Marquette CH, et al. Indications for flexible versus rigid bronchoscopy in children with suspected foreign-body aspiration. Am J Respir Crit Care Med. 1997;155:1676–9.

    PubMed  CAS  Google Scholar 

  22. Zaytoun GM, Rouadi PW, Baki DH. Endoscopic management of foreign bodies in the tracheobronchial tree: predictive factors for complications. Otolaryngol Head Neck Surg. 2000;123:311–6.

    Article  PubMed  CAS  Google Scholar 

  23. Li S, Liu Y, Tan F, et al. Efficacy of manual jet ventilation using Manujet III for bronchoscopic airway foreign body removal in children. Int J Pediatr Otorhinolaryngol. 2010;74:1401–4.

    Article  PubMed  Google Scholar 

  24. Castro M, Midthun D, Edell E, et al. Flexible bronchoscopic removal of foreign bodies from pediatric airways. J Bronchol. 1994;1:92–8.

    Article  Google Scholar 

  25. Swanson KL, Prakash UB, Midthun DE, et al. Flexible bronchoscopic management of airway foreign bodies in children. Chest. 2002;121:1695–700.

    Article  PubMed  Google Scholar 

  26. Swanson KL, Prakash U, McDougall JC, et al. Airway foreign bodies in adults. J Bronchol. 2003;10: 107–11.

    Article  Google Scholar 

  27. Rodrigues A, Scussiatto E, Jacomelli M, et al. Bronchoscopic techniques for removal of foreign bodies in children’s airways. Pediatr Pulmonol. 2012; 47:59–62.

    Article  PubMed  Google Scholar 

  28. Lando T, Cahill A, Elden L. Distal airway foreign bodies: importance of a stepwise approach, knowledge of equipment and utilization of other services’ expertise. Int J Pediatr Otorhinolaryngol. 2011;75: 968–72.

    Article  PubMed  CAS  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Pulmonary and Critical Care Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, USA

    Karen L. Swanson D.O.

Authors
  1. Karen L. Swanson D.O.
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Correspondence to Karen L. Swanson D.O. .

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Editors and Affiliations

  1. MD Anderson Cancer Center, Houston, TX, Department of Pulmonary Medicine, Bellvitge University Hospital, Barcelona, 08907, Spain

    Jose Pablo Díaz-Jimenez

  2. Clinica Y Maternidad Colon, Pulmonary Department, Mar Del Plata, Buenos Aires, 7600, Argentina

    Alicia N. Rodriguez

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Swanson, K.L. (2013). Endoscopic Foreign Body Removal. In: Díaz-Jimenez, J., Rodriguez, A. (eds) Interventions in Pulmonary Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-6009-1_32

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  • DOI: https://doi.org/10.1007/978-1-4614-6009-1_32

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-6008-4

  • Online ISBN: 978-1-4614-6009-1

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