Extraction of Large Tracheal Foreign Bodies through a Tracheostoma under Bronchoscopic Control

Swensson, Erik E.; Rah, Kang H.; Kim, Moon C.; Brooks, James W.; Salzberg, A.M.

doi:10.1016/s0003-4975(10)62588-x

Cited by 28 publications

(12 citation statements)

References 5 publications

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“…Tracheal or bronchial foreign bodies larger than the subglottic region cannot be securely grasped with forceps for safe removal through the usual route. In these circumstances, open surgical removal of an airway foreign body is preferred to bronchoscopic removal [6,9,10]. If the foreign bodies cannot be removed because of size discordance, an elective tracheostomy may be performed over the ventilating bronchoscope.…”

Section: Discussionmentioning

confidence: 99%

The value of open surgical approaches for aspirated pen caps

Ülkü

Önen

Onat

et al. 2005

Journal of Pediatric Surgery

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Section: Discussionmentioning

confidence: 99%

The value of open surgical approaches for aspirated pen caps

Ülkü

Önen

Onat

et al. 2005

Journal of Pediatric Surgery

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“…Outras indicações de abertura traqueal são remoção de CE pontiagudos, cujas pontas trancam na subglote ou nas cordas vocais, e quando o CE impacta na região subglótica e provoca uma obstrução aguda [3][4][5] . Também em pacientes com prévia traqueostomia, como os referidos neste estudo, a introdução de equipamento endoscópico pela traqueostomia facilita a retirada de grandes materiais aspirados para a via aérea.…”

Section: Discussionunclassified

Remoção de corpo estranho da via aérea de criança por broncoscopia através de traqueotomia ou traqueostomia

Fraga¹,

Pires²,

Komlós³

et al. 2003

J. Pediatr. (Rio J.)

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Trabalho apresentado no XXIII Congresso Brasileiro de Cirurgia Pediátrica, realizado em Goiás, de 3 a 7 de novembro de 2002.Artigo submetido em 12.12.02, aceito em 26.03.03. ResumoObjetivo: a maioria dos corpos estranhos aspirados para a via aérea é removida através de endoscopia respiratória. Em situações raras, a retirada deste material tem que ser realizada sob controle endoscópico, através de traqueotomia ou traqueostomia. A seguir, relatamos casos de crianças cuja remoção de corpos estranhos aspirados para a via aérea foi realizada por abertura traqueal.Descrição: revisão retrospectiva de prontuários, com relato de três crianças que aspiraram corpos estranhos para a via aérea. A primeira apresentou ruptura da cânula de traqueostomia, com aspiração da porção distal da mesma. Foi realizada remoção endoscópica através do traqueostoma. A segunda aspirou tampa de caneta, que não conseguia ser removida endoscopicamente, pois a mesma trancava e não passava na região subglótica. Foi realizado, então, traqueotomia cervical e remoção do corpo estranho sob controle endoscópico. A terceira apresentou corpo estranho aspirado para o brônquio principal esquerdo (palito de madeira), que foi removido através de broncoscopia, realizada pelo orifício da traqueostomia. Todas as crianças toleraram o procedimento endoscópico, com remoção do corpo estranho. No paciente em que foi realizada traqueotomia, a traquéia foi suturada após retirada do corpo estranho, não havendo necessidade de realização de traqueostomia. Nas crianças com traqueostomia prévia, a mesma foi recolocada após a retirada do corpo estranho.Comentários: uma minoria dos corpos estranhos aspirados para a via aérea de criança não pode ser removido somente por endoscopia. Quando o corpo estranho é demasiadamente largo que não passa na região subglótica, ou pontiagudo que possa traumatizar a via aérea, a remoção pode ser realizada por endoscopia, através de traqueotomia ou traqueostomia. AbstractObjective: most foreign bodies in the airway are removed by respiratory endoscopy. Rarely, the removal of the foreign body has to be performed through endoscopic control by tracheotomy or tracheostomy. This article reports three cases of foreign body removal in children performed by tracheal opening.Description: retrospective review of records with report of three cases of children who aspirated foreign bodies into the airway. In the first case, there was rupture of the tracheostomy tube, with aspiration of its distal portion. Endoscopic removal was performed by tracheostomy. The second child aspirated a pen cap. It could not be removed by endoscopy because it would not pass through the subglottic region. Cervical tracheotomy was performed and the foreign body was removed with endoscopic control. In the last case, the foreign body was in the left main bronchus. It was removed by bronchoscopy through tracheostomy opening. All children presented good outcome after the endoscopic procedure. The trachea of the patient submitted to tracheotomy was sutured after the foreign body r...

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“…4 Other indications for tracheotomy are the removal of sharply pointed FBs whose points lodge in the subglottis or in the vocal cords and when the FB impacts the subglottic region and provokes an acute obstruction. 3,5,6 In the present study 3 patients required tracheotomy for removal of large impacted FB. Two of them had impacted organic food matter in the trachea, i.e.…”

Section: Discussionmentioning

confidence: 76%

“…In these circumstances, open surgical removal of an airway foreign body is preferred to bronchoscopic removal. [10][11][12] Open surgical procedures include tracheotomy, thoracotomy, and bronchotomy. Ulku R et al, performed thoracotomy and bronchotomy in cases in which removal of pen cap failed because of immobility, very distal bronchial placement, and/or impossible grasping owing to severe circular bronchial edema immediately proximal to foreign body, slippery surface, and the pen cap having settled completely in the bronchus.…”

Section: Discussionmentioning

confidence: 99%

The management of complicated airway foreign bodies in children: our institutional experience

Aihole¹,

Narendra²,

Deepak³

et al. 2016

Int J Contemp Pediatr

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INTRODUCTIONForeign body (FB) aspiration is typically seen in preschool children. 1,2,4Exploring nature and inquisitiveness of these babies is commonly attributed for FB aspiration. 2,4,5 The majority of acute foreign body aspirations presents dramatically and can be safely extracted with rigid or flexible bronchoscopy with optical forceps.5 However, on rare occasions these patients may present with complications related to FB impaction and its effects distal to it. We present our study on complicated airway FBs and their surgical management in children. ABSTRACTBackground: Foreign body (FB) aspiration is typically seen in preschool children. The main objective was to study the utility of open surgical treatment for complicated airway foreign bodies in children. Methods:This was a retrospective analysis of data pertaining to complicated airway foreign bodies managed at our institution between 1997 January to December 2015. The demographic data, clinical presentation, radiological studies, surgical management, complications, duration of hospital stay and follow up were recorded and analysed. The diagnosis of FB aspiration was made from documented clinical features and radiological investigations. The treatment included rigid bronchoscopy and surgical interventions as and when required. Results: During the study period of 120 months, a total of 635 children with FB aspiration were treated at our institution. All of them underwent initially, rigid bronchoscopy and attempted FB retrieval. It was successful in 624 patients and 11 patients had complicated airway FB which could not be retrieved endoscopically. Among eleven patients analysed in the present study, 7 were males and 4 were females. The age of the patients ranged from 6 months to 16 years, the average age being 5.7 years. All of them did well postoperatively except one mortality. Conclusions: Timely intervention with the experienced surgical team would minimize the complication rate and mortality rate. The concomitant performance of a tracheotomy is indicated for patients who have aspirated particularly wide FBs, which do not pass the subglottic region and in sharply pointed FBs whose points lodge in the subglottic region presenting with respiratory distress. Open surgical procedures including thoracotomy and bronchotomy for retrieval of impacted bronchial FB are invaluable adjunctive procedures for management of complicated FB aspirations.

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Extraction of Large Tracheal Foreign Bodies through a Tracheostoma under Bronchoscopic Control

Cited by 28 publications

References 5 publications

The value of open surgical approaches for aspirated pen caps

The value of open surgical approaches for aspirated pen caps

Remoção de corpo estranho da via aérea de criança por broncoscopia através de traqueotomia ou traqueostomia

The management of complicated airway foreign bodies in children: our institutional experience

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