Bronchoscopic techniques for removal of foreign bodies in children's airways

Abstract

Introduction The management of airway foreign bodies (AFB) can be a dramatic situation in the emergency treatment of children and different techniques have been used to improve the therapeutic success and minimize risks. Objective to describe the bronchoscopic techniques used in the treatment of AFB in children referred to the Service of Respiratory Endoscopy of HC-FMUSP. Patients and methods Retrospective analysis of 78 children who underwent bronchoscopy for foreign body removal, at our Service from February 2003 to April 2008. Results 78 patients with an AFB, aged 08 months to 14 years, with 39 being organic and 39 inorganic foreign bodies. Nine foreign bodies were located in the central airway (four in the larynx and five in the trachea), 34 in the right bronchial tree and 33 in the left bronchial tree. There was bilateral aspiration in two cases. All patients were initially submitted to diagnostic flexible bronchoscopy. A rigid bronchoscope was used in 39 cases; a flexible bronchoscope in 23 and an association of techniques in 15 cases (rigid bronchoscopy, flexible bronchoscopy, suspension laryngoscopy, and fluoroscopy). Discussion Although the rigid bronchoscopy is considered the main tool for the removal of foreign bodies from airways, other useful techniques deserve attention as part of the medical training. Conclusion The knowledge and association of different methods in pediatric bronchoscopy add the benefits of one method to another, minimizing the chances of therapeutic failure. © 2011 Wiley Periodicals, Inc.