Clinical Experiences of Removing Foreign Bodies in the Airway and Esophagus with a Rigid Endoscope: A Series of 3217 Cases from 1970 to 1996

Abstract

This study examined 11,333 rigid endoscopy procedures performed in the Department of Otolaryngology, National Taiwan University Hospital, during a 27-year period from 1970 to 1996. Among these cases, 3217 were performed to remove foreign bodies from the airway (459 cases, 14.3%) and esophagus (2758 cases, 85.7%). Retrospective analysis of these data revealed that peanuts (217 cases) and animal bones (1184 cases) were the most frequent foreign bodies encountered in the airway and esophagus, respectively. The successful rate of removal of these foreign bodies was 99.9% (3213/3217). The complication rate was only 0.2% (8/3217), and the mortality rate was less than 0.1% (2/3217). On the basis of these results, we conclude that foreign bodies in the airway and esophagus can be removed safely under direct visualization through rigid endoscopy with relatively few complications. A significant finding in this study is the declining trend in the number of cases in recent years. Despite the decline in the number of procedures, endoscopic removal of foreign bodies remains as a vital skill of the aerodigestive tract surgeon.

Rigid bronchoscopy for the suspicion of foreign body in the airway

“…In this study, 1379 of 1856 children (74.3%) were between 5 days old and 3 years old, just as reported in the literature [1,6], and the ratio of male to female was in favor of males; 58.6 and 41.4%, respectively. There are many speculations regarding the pathophysiology of FB aspiration.…”

“…Since Gustav Killian's first demonstration [2], peroral rigid endoscopy has been the standard approach for removal of FBs in the airway. Some authors have advocated other methods, including the Foley catheter technique [3,4], and flexible fiberoptic endoscopy [5] but rigid endoscopy remains the most widely used technique for removal of FBs in the airway [6].…”

Headscarf pin, a sharp foreign body aspiration with particular clinical characteristics

“…Generally, the most common aspirated foreign body (FB) is dry nuts or beans [4][5][6]. However, the nature of aspirated FB is inXuenced by many factors, including age, sex, nutritional habits, geographical area and socioeconomic status [7].…”

Scarf pins sharp metallic tracheobronchial foreign bodies: Presentation and management

“…Approximately 75% occur in children younger than 3 years old [1,2]. In adults, foreign body (FB) aspiration is seen most commonly after the sixth decade of life and is usually the result of the failure of airway protective mechanisms [1].…”