Flexible bronchoscopy as the first-choice method of removing foreign
bodies from the airways of Children
Abstract
Introduction: The aspiration of foreign bodies into the airway (AFB) is
an important cause of death in children worldwide. The incidence is
higher in children aged 1-2 years. The presentation and severity depends
in the degree of airway obstruction. In the event of a compatible
clinical history, a bronchoscopy evaluation is needed. Methods:
Retrospective study. Included pediatric patients who underwent
bronchoscopy for removal of AFB at the Service of Respiratory Endoscopy
in the period from January 2014 until June 2020. We reviewed medical and
bronchoscopy records, collected information about the equipment used,
foreign body location and nature, age, sex, success rate and
complications. Results: 40 pediatric patients were treated. Children
under 3 years accounted for 51% of cases with a peak incidence between
1 to 2 years accounting for 35.5% of cases. The majority of the
removals were done by a flexible bronchoscopy (90%), using a basket
(47,5%) or a rat tooth forceps (35%). The overall removal success rate
was 100%. Complications occurred in 3 cases (7.5%). No deaths were
reported. Discussion: The bronchoscopic removal of AFB in children is a
complex and demanding procedure with a high potential for complications.
Historically, rigid bronchoscopy has been the gold standard for the
treatment of pediatric foreign body inhalation, but several authors have
described flexible bronchoscopy as a diagnostic and therapeutic method
for the removal of AFB. Our results show that, in most cases, flexible
bronchoscopy is a safe and effective for the removal of AFB.