Management of laryngeal foreign bodies in children

Area of Science:

• Pediatric Emergency Medicine
• Otolaryngology
• Pediatric Pulmonology

Background:

• Foreign body aspiration is a common pediatric emergency, with food items prevalent in younger children and non-food items in older ones.
• Laryngeal impaction is rare; most foreign bodies lodge lower in the airway.
• Subglottic impaction, particularly in children under two, presents unique diagnostic and management challenges.

Observation:

• Two cases of foreign body aspiration with subglottic impaction in children under two years old are presented.
• Both cases involved impaction occurring after blind finger sweeping attempts for foreign body removal.
• Clinical presentation, diagnostic investigations, and therapeutic strategies for these rare scenarios were observed.

Findings:

• Subglottic impaction of foreign bodies is an uncommon but serious complication in young children.
• Blind finger sweeping, intended to remove foreign bodies, can paradoxically lead to deeper impaction, specifically in the subglottic region.
• Early and accurate diagnosis is crucial for effective management of subglottic foreign bodies.

Implications:

• Highlights the risks associated with blind finger sweeps in suspected foreign body aspiration.
• Emphasizes the need for careful diagnostic evaluation and specialized techniques for foreign body removal in pediatric patients.
• Contributes to understanding rare airway foreign body presentations and informs clinical practice guidelines for pediatric foreign body ingestion and aspiration.