25-Year Review of the Abundance and Diversity of Radiopaque Airway Foreign Bodies in Children

Abstract

This study was conducted to review the abundance and diversity of radiopaque foreign bodies over a 25-year period. Overall records of 1,114 patients who underwent rigid bronchoscopy due to foreign body aspiration in the tertiary centres, Imam Khomeini and Apadana; over a 25-year period (1989-2014) were reviewed. History, clinical findings, plain radiography and bronchoscopic findings, foreign body (FB) aspiration (whether radiolucent or radiopaque), time from onset of symptoms until hospitalization, and delay time were all considered. The male/female ratio was 1.53. Most patients were aged 1-3 years (53.94 %). The most common location of foreign bodies was the right main bronchus (54.57 %). The most common type of radiopaque foreign body was meat, chicken and big fish bones (4.84 %) followed by metal objects (4.39 %). Coughing (70.82 %) and cyanosis (22.80 %) were the most common symptoms. The most common radiological findings were emphysema (32.31 %). Given that the radiological findings are highly specific as regards the detection of radiopaque FB, radiographic examination prior to bronchoscopy for FB localization and shortening the time of bronchoscopy in patients with a history of radiopaque FB aspiration can be helpful. Due to the high morbidity and mortality caused by prolong and repeated bronchoscopy, the use of newer techniques and equipment in shortening extraction time of the foreign bodies should be considered in future researches.

Correlative factors for the location of tracheobronchial foreign bodies in infants and children

“…The rank correlation coefficient was used to describe the association between two quantitative variables, or between a quantitative and categorical variable, which were not normally distributed. For the association analysis of two categorical variables with at least one variable as an unordered categorical variable, the independence of two attributes was first evaluated using χ 2 -test, according to the contingency tables obtained by cross classification and counting (if these could not be evaluated using χ 2 test, Fisher's exact probability test was used). Then, the correlation coefficient was calculated.…”

“…Tracheobronchial foreign body is one of the most common critical diseases in otolaryngology-head and neck surgery. Due to anatomy, physiology, eating habits, infant curiosity and other factors, tracheobronchial foreign body mostly occurs in 1-3-year-old infants; and the complication rate and mortality are relatively high (1)(2)(3)(4). The severity depends largely on the nature of the foreign body and the degree of obstruction determined by the location of the foreign body.…”

Cuerpo extraño bronquial: Experiencia de los últimos 18 años en Hospital Guillermo Grant Benavente, Concepción, Chile

“…Lo anterior difiere de publicaciones extranjeras 8,[13][14][15] , la última revisión realizada en nuestro hospital el año 1984 y de la última serie publicada en Chile el año 1953, pero es similar al metaanálisis anteriormente mencionado 10 . Encontramos un segundo peak de incidencia en el grupo de seis a once años, con un fuerte predominio de CEVA inorgánicos, especialmente tapas de lápices y chinches, a diferencia del grupo de menores de tres años, donde el maní constituyó el CEVA por excelencia con un p <0,05 respecto a los otros grupos de edad, similar a otros reportes 10 .…”

“…El éxito de la extracción mediante la BR fue de 96,8% lo cual está acorde con la literatura [1][2][3]7,8,[14][15][16] . Por fortuna no tuvimos complicaciones relevantes.…”

“…Por fortuna no tuvimos complicaciones relevantes. En siete pacientes (7,4%) hubo que extraer el CEVA en un segundo intento, lo cual es algo por sobre el 0,97%-4,4% encontrado 14,15 . En tres casos (3,2%) hubo que realizar toracotomía, lo cual concuerda con la literatura 1,7,14,15 .…”