Cryoextraction: A novel approach to remove aspirated chewing gum

Abstract

The extraction of aspirated foreign bodies can prove challenging at times, requiring even rigid bronchoscopy. Cryotherapy probes have been reported to help with extraction of foreign bodies. We present a case where successful “cryoextraction” was performed on an aspirated chewing gum. The case highlights the fact that this technique is useful to extract all materials that have water content. This technique can be performed through flexible bronchoscopy and can save patients from more aggressive approaches.

Removal of foreign bodies in children's airways using flexible bronchoscopic CO2cryotherapy

“…Although the cryotherapy removed parts of the plastic covering, the main foreign body was wrapped by granulation tissue, and the cryotherapy failed. It may also due to the low water content of the plastic (compared to that of organic materials such as nuts) may have made cryoadhesion more difficult in this case …”

“…These authors recommended the use of cryotherapy for the removal of aspirated foreign bodies that are soft and amenable to freezing. Another group recently reported using cryoextraction with a flexible bronchoscope to remove aspirated chewing gum from a patient and recommended the procedure for materials that have a high water content …”

Bronchoscopic cryoextraction: a novel approach for the removal of massive endobronchial blood clots causing acute airway obstruction

“…Freezing also leads to shrinking of the foreign objects, thereby easily separating them from inflamed mucosa and facilitating their removal. An additional advantage of this technique is the shorter learning curve needed to utilize the cryoprobe compared to the prolonged training required to master rigid bronchoscopy (7). One concern expressed about the cryoextraction of the massive endobronchial clots is that a large 'frozen clot' might be difficult to extract through the smaller sized endotracheal tubes and, if dislodged in that process, could lead to obstruction of the ET tube.…”

Bronchoscopic Cryotherapy. Clinical Applications of the Cryoprobe, Cryospray, and Cryoadhesion

“…Success with cryoextraction has been reported when treating various foreign bodies including blood clots, chewing gum, metal objects (despite their lack of water content), pills, and food particles (58)(59)(60)(61)(62)(63)(64)(65). Foreign bodies that contain sufficient water for freezing and adhering to the cryoprobe, and that are friable and difficult to remove en-bloc with standard forceps are ideal.…”