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A Christmas tree in the larynx
Jenny Philip1, Mary Bresnihan, Neil Chambers
1Department of Anaesthesia and Department of Ear, Nose and Throat, Princess Margaret Children's Hospital, Perth, WA, Australia. jennyphilip@hotmail.com
Paediatric Anaesthesia
|December 17, 2004
Summary
A 2-year-old boy experienced severe airway obstruction due to a foreign body lodged in his larynx. Prompt bronchoscopy revealed a plastic Christmas tree ornament, necessitating a tracheostomy for removal and eventual recovery.
Area of Science:
- Pediatric Otolaryngology
- Pediatric Pulmonology
- Foreign Body Aspiration
Background:
- Foreign body aspiration is a common cause of pediatric airway emergencies.
- Chronic hoarseness and noisy breathing in children can indicate underlying laryngeal pathology.
- Delayed diagnosis of airway foreign bodies can lead to significant morbidity.
Observation:
- A 2-year-old boy presented with acute upper airway obstruction after 15 months of progressive noisy breathing and hoarseness.
- Fiberoptic laryngotracheal bronchoscopy identified a plastic Christmas tree ornament lodged in the larynx, causing near-complete obstruction.
- The foreign body was embedded within granulomatous tissue, requiring tracheostomy for safe extraction.
Findings:
- Successful removal of the laryngeal foreign body via tracheostomy and bronchoscopy.
- Decannulation of the tracheostomy 12 days post-procedure.
- Gradual normalization of the child's voice post-removal.
Implications:
- Highlights the importance of considering chronic, subtle symptoms in pediatric airway foreign body diagnosis.
- Emphasizes the utility of flexible bronchoscopy in evaluating pediatric laryngeal and tracheal pathology.
- Underscores the potential for delayed presentation of foreign body aspiration, even with seemingly benign objects.