Tracheobronchial Foreign Body Aspirations in Children: A Retrospective Analysis of 980 Patients

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Between January 1987 and May 1997, hospital records of 980 children (587 boys and 393 girls) ≤15 years old referred to our clinic for suspected airway foreign body aspiration were reviewed. Rigid bronchoscopy was performed for all patients. Foreign bodies were successfully removed in 918 (93.7%) patients; 740 (75.5%) presented with a definite history of foreign body aspiration and 178 (18.2%) did not. In 62 patients (6.3%), bronchoscopy was negative. Watermelon seeds, found in 364 (39%) patients, were the most common foreign bodies. The average length of hospital stay for those who were admitted within 24 hours of the aspiration was < 1 day (20 hours); however, for those who admitted >24 hours after the aspiration event, average length of stay was 3.1 days (p < 0.001). Open surgical procedures were required for 17 (1.7%) patients; tracheostomy through the ventilating bronchoscope for 5, lobectomy for 2, and bronchotomy for 10. Bronchial rupture related to bronchoscopy occurred in 3 patients; 2 died postoperatively. The overall mortality rate was 0.8%. We conclude that parental education is mandatory for decreasing the incidence of airway foreign body aspirations. Our negative bronchoscopy rate (6.3%) is not high compared to other reports and even higher rates may be needed to prevent missed foreign body aspiration and its consequent complications. Expert anesthesia is essential and bronchoscopy should be performed by an experienced staff, if a lower incidence of complications and better results are to be expected.

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