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The Transition of Pediatric Tracheobronchial Foreign Body Cases in the Past 36 Years: A Retrospective Single-Center
Hiyori Takahashi1, Jun Suzuki1, Ryoukichi Ikeda2
1Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine.
Insights
Pediatric tracheobronchial foreign bodies (TFBs) decreased over 36 years, with older children and fewer peanut aspirations. Diagnosis and treatment improved, reducing delayed detection.
Area of Science:
- Pediatric Otolaryngology
- Pediatric Pulmonology
- Emergency Medicine
Background:
- Tracheobronchial foreign bodies (TFBs) are common pediatric airway emergencies.
- Understanding trends in TFB cases is crucial for effective management.
Purpose of the Study:
- To analyze changes in clinical characteristics of pediatric TFB patients over 36 years.
- To compare early (1986-2005) and late (2006-2021) periods for TFB demographics, causes, and treatment.
Main Methods:
- Retrospective review of 85 pediatric patients (0-10 years) with TFBs at Tohoku University Hospital (1986-2021).
- Comparison of patient characteristics, diagnostic methods, and treatments between two time periods.
Main Results:
- A decrease in TFB patient incidence was observed (3.2 to 1.3 per year).
- The proportion of older children (>3 years) increased significantly in the later period.
- Peanut aspiration decreased significantly (68.8% to 38.1%), and delayed diagnosis (>1 month) was eliminated.
Conclusions:
- Significant shifts in pediatric TFB demographics and etiology have occurred.
- Improved diagnostic and treatment strategies have reduced delayed TFB detection.
- Prevention and management approaches for pediatric TFBs should adapt to these evolving trends.
Abstract:
Tracheobronchial foreign bodies (TFBs) are pediatric airway emergencies frequently seen. We aimed to examine the changes in the clinical characteristics of pediatric TFB patients in a single institution within the past 36 years. We retrospectively reviewed the data of 85 patients aged 0-10 years with TFBs lodged in the trachea or bronchus admitted at the Department of Otolaryngology-Head and Neck Surgery at Tohoku University Hospital between 1986 and 2021. We also compared the characteristics, diagnostic methods, and treatments of the previous 64 cases (1986-2005) with those of the recent 21 cases (2006-2021). The number of TFB patients decreased later in this study (3.2 vs. 1.3 patients per year). The proportion of TFB patients aged > 3 years was significantly higher in the later period (6.3% vs. 23.8%, p = 0.038). Peanut was the most common cause of TFBs in both periods, and the overall incidence of peanut aspiration significantly decreased in the later period (68.8% vs. 38.1%, p = 0.019). No patient had an undetected TFB for more than 1 month after the onset of symptoms in the later period. Foreign body extraction using rigid bronchoscopy was performed in all patients earlier, whereas flexible bronchoscopy was used in 14.3% later. Our study revealed a recent trend in the clinical characteristics of pediatric TFB patients in a single institution in Northeast Japan. The prevention and treatment of pediatric TFBs should be considered following the recent trends.
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