The role of flexible bronchoscopy accomplished through a laryngeal mask airway in the treatment of tracheobronchial foreign bodies in children

Suzen, Alev; Karakuş, Süleyman Cüneyt; Ertürk, Nazile

doi:10.1016/j.ijporl.2018.12.006

Cited by 19 publications

(65 citation statements)

References 19 publications

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“…Type of anesthesia is an issue of controversy with different Centers choosing spontaneous ventilation through laryngeal mask [11,13]. We agree with Authors that report that general anesthesia with muscle paralysis seems to provide a better control of the ventilation and to decrease life-threatening complications in children aged less than four years [25][26][27].…”

Section: Discussionsupporting

confidence: 79%

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Tracheobronchial foreign body aspiration in children aged ≤ 2 years: the use of ﬂexible bronchoscopy and urology stone retrieval basket in emergency setting

2021

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Objective: Tracheobronchial aspiration of foreign body in children is an emergency that can lead to major complications. In the last years flexible bronchoscopy has gained popularity for foreign bodies retrieval in the pediatric population, yet the small size of the pediatric airway and of the flexible bronchoscope channel limit the availability of instruments during the procedure. Aim of this paper is to describe our experience in treating foreign bodies tracheobronchial aspiration in children aged 2 years or less by means of flexible bronchoscope and an urology stone retrieval basket. Methods: A review of endoscopic foreign bodies removal by means of flexible bronchoscopy and urology stone retrieval basket has been carried out in children ≤ 2 years that presented at the Emergency Room of our hospital from 2005 to 2019. In the paper, we analyze characteristics of patients, timing of bronchoscopy, instruments and operative management. Results: There were 25 patients with a mean age of 20 ± 3.8 months. Organic material was the most frequent observed foreign body. Association of main bronchus and distal bronchi was the preferred site of the foreign body in 19 patients and the right side of the bronchial tree was involved in 17 cases. Complications occurred in one case. Mean operation time was 37 ± 20 minutes. Conclusions: The use of flexible bronchoscope can be helpful in handling endoscopic removal of tracheobronchial foreign bodies in toddlers. The use of the urology stone retrieval basket resulted very effective in all shapes of foreign bodies and/or when the object was located in the distal bronchi.

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Section: Discussionsupporting

confidence: 79%

“…Flexible bronchoscopy raised his popularity in the last years [9][10][11] due to the increasing availability of proper instruments and the possibility to explore the distal tracheobronchial tree [9,10]. A combination of the two techniques is also advocated by some Authors [6,12].…”

Section: Introductionmentioning

confidence: 99%

Tracheobronchial foreign body aspiration in children aged ≤ 2 years: the use of ﬂexible bronchoscopy and urology stone retrieval basket in emergency setting

2021

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“…A high index of clinical suspicion is required in order to diagnose a FBA since an eyewitness to the aspiration episode is usually not present and pediatric patients are unable to communicate verbally 4,16 . The key clinical manifestation of a tracheobronchial FBA is the "penetration syndrome", which consists of acute onset of asphyxia, with stridor and cyanosis after an episode of choking and coughing that may potentially lead to respiratory failure 9,17,18 .…”

Section: Introductionmentioning

confidence: 99%

“…obstructive emphysema with air-trapping, atelectasis, and more rarely pneumothorax or pneumomediastinum). However, pathologic findings may be absent in both X-rays 14,16,[23][24][25] and Chest CT 8 . Consequently, if history and clinical findings are suggestive of a FBA, physicians should not be deterred from performing a bronchoscopy, due to negative radiological findings 17,18,24 .…”

Section: Introductionmentioning

confidence: 99%

“…Advantages of rigid bronchoscopy (RB), include the ability to control the airway and ventilate, the wide working channel of rigid bronchoscopes, and the availability of a variety of combined equipment 9,18 . On the contrary, rigid bronchoscopes are not available at all medical centers, general anesthesia 16,27 is necessary, and a significant degree of training and skill for the operator to become proficient are required 5,18 . Moreover, recorded complications associated with RB, although rare, include subglottic edema, tracheal laceration, bronchospasm, pneumothorax, pneumomediastinum, and hypoxic arrest 8,9,16,17,28,29 .…”

Section: Introductionmentioning

confidence: 99%

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Flexible bronchoscopy in foreign body removal in the pediatric population: A Systematic Review

Chantzaras

Panagiotou

Karageorgos

et al. 2021

Preprint

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Background: Foreign body aspiration (FBA) in the tracheobronchial tree is a common problem in the pediatric population. Rigid bronchoscopic procedure is currently the gold standard method for treatment in pediatric patients, whereas recent reports present flexible bronchoscopy as an alternative method. The aim of this study was to summarize all available evidence regarding the application and the success rate of flexible bronchoscopy in foreign body (FB) removal. Methods: Systematic review of the use of flexible bronchoscopy as the first-line treatment in FBA cases in PubMed from 2001 to 2021. Results: Out of 243 citations, 23 studies were included on the use of flexible bronchoscopic procedure as a treatment of choice in 2,587 children with FBA. The FBs were successfully removed in 2,254/2,587 (87.1%) patients with a low complication rate. The majority of FBs retrieved were organic materials 1,073/1,370 (78.3%), and they were most commonly lodged in the right bronchial tree 708/1,401 (50.5%). General anesthesia was applied in most studies (14/23) before proceeding to a flexible bronchoscopy and laryngeal mask airways (LMAs) were mostly used (10/23 studies) to secure the airway during the procedure. Ancillary equipment, usually forceps 1,544/1808 (85.4%) assisted in the FB retrieval. Conclusion: The use of flexible bronchoscopy is shown to be a feasible and safe alternative therapeutic procedure in FBA cases. There is a need for development of extraction equipment and techniques to assist the procedure. Finally, future studies focusing on the comparison between clinical outcomes of flexible and rigid bronchoscopies are necessary.

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A transglottic foreign body in the airway of an infant

Singh

2020

Anaesthesia Reports

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The role of flexible bronchoscopy accomplished through a laryngeal mask airway in the treatment of tracheobronchial foreign bodies in children

Cited by 19 publications

References 19 publications

Tracheobronchial foreign body aspiration in children aged ≤ 2 years: the use of ﬂexible bronchoscopy and urology stone retrieval basket in emergency setting

Tracheobronchial foreign body aspiration in children aged ≤ 2 years: the use of ﬂexible bronchoscopy and urology stone retrieval basket in emergency setting

Flexible bronchoscopy in foreign body removal in the pediatric population: A Systematic Review

A transglottic foreign body in the airway of an infant

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