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[Tracheotomy in the child with a foreign body in the lower respiratory passages]
Insights
In a 15-year study, 137 children inhaled foreign bodies, with peanuts being common organic culprits lodged in the larynx. Tracheostomy, often performed late, increased risks, highlighting challenging conditions for pediatric airway foreign body management.
Area of Science:
- Pediatric Otolaryngology
- Respiratory Medicine
- Public Health
Background:
- Foreign body aspiration in children poses significant risks to the respiratory tract.
- Early diagnosis and intervention are crucial for favorable outcomes.
- Management challenges exist, particularly in resource-limited settings.
Purpose of the Study:
- To analyze the characteristics and management of foreign bodies in the inferior respiratory tracts of children.
- To evaluate the role and impact of tracheostomy in managing pediatric airway foreign bodies.
- To highlight the challenges faced in a university hospital setting.
Main Methods:
- Retrospective analysis of 137 pediatric cases admitted over 15 years.
- Data collected included patient demographics, foreign body type and location, and management procedures.
- Surgical interventions, including tracheostomy and foreign body extraction, were documented.
Main Results:
- 137 children treated for foreign bodies in the inferior respiratory tract; males predominantly affected.
- Organic foreign bodies, especially peanuts, accounted for 81%; 76% were found in the larynx.
- Tracheostomy was performed in 48 children (35%), often late and preceding extraction (90% of tracheostomies).
Conclusions:
- Foreign body inhalation in children, particularly organic materials in the larynx, requires prompt management.
- The frequent and often delayed use of tracheostomy in this cohort is associated with increased morbidity and mortality.
- Arduous working conditions contribute to the complexities of managing pediatric airway foreign bodies.
Abstract:
In 15 years period, 137 children with foreign bodies of inferior respiratory tracts were admitted in the otorhinolaryngology and head and neck department of the University of Dakar. For 48 of them, generally late admitted, a tracheostomy was performed. Male children were most affected. About 81% of the removed foreign bodies were organic, dominated by peanuts. 76% of the foreign bodies were found in the larynx. Tracheostomy had been realized before extraction of foreign body for 90% of the cases and after extraction for the others 10%. One case of death was to be deplored. This critical place of tracheostomy increases the morbidity and the mortality in relation with the inhalation of foreign body. This unusual practice of tracheostomy illustrates the arduousness of our working conditions.