Airway foreign bodies (FB): a 10-year review

Area of Science:

• Pediatric Otolaryngology
• Pediatric Pulmonology
• Pediatric Emergency Medicine

Background:

• Aspiration of foreign bodies is a significant risk in infants and young children due to their smaller airway size.
• Serious complications, including airway obstruction and death, are more common in younger children with aspirated foreign bodies.
• Timely diagnosis and intervention are critical for successful management and prevention of morbidity.

Purpose of the Study:

• To review cases of airway foreign body removal in children treated with direct laryngoscopy and bronchoscopy (DLB).
• To identify factors influencing diagnostic delays and procedural outcomes.
• To emphasize the importance of early diagnosis and public awareness in reducing foreign body aspiration complications.

Main Methods:

• Retrospective chart review of pediatric patients undergoing DLB for airway foreign body removal (1987-1997).
• Data collected included patient demographics, clinical presentation, pre-operative imaging, reasons for diagnostic delay, DLB findings, procedure duration, and foreign body types.
• Analysis of complications and reasons for repeat procedures.

Main Results:

• Serious complications like airway obstruction and death are more prevalent in infants and younger children.
• A history suggestive of foreign body aspiration warrants diagnostic endoscopy, potentially aided by imaging.
• Chest and airway radiographs, especially fluoroscopy, can enhance diagnostic accuracy and speed.

Conclusions:

• Fluoroscopy should be considered a universal initial diagnostic technique for suspected airway foreign bodies.
• Early diagnosis is paramount for uncomplicated management of foreign body aspiration.
• Physician education and public awareness campaigns are essential to decrease morbidity and mortality, with parental guidance on avoiding hazardous foods and objects being key.