Unusual Tracheobronchial Foreign Bodies: Clinical Presentation and Management in Adults

Abstract

Introduction: Tracheobronchial foreign body (TFB) aspiration in adults is rare;however, its prevalence increases with age. As in children, it is a life-threatening respiratory emergency. Materials and Methods: This is a retrospective study of 30 cases collected in our Ear Nose and Throat department over a 12-year period (2010-2022). Results: There were 27 women and 3 men with a mean age of 20 years, ranging from 17 to 37 years. Three patients were intubated and ventilated for polytrauma after a traffic accident. The average consultation time was 1.2 days. Penetration syndrome was the main presenting symptom in all cases. The imaging showed a radiopaque foreign body in all cases. FB was on the left site in 21 cases (70%), on the right site in 5 cases (17%), and on the laryngotracheal axis in 4 cases (13%). Extraction was performed by rigid bronchoscopy in all cases, after a single attempt in 26 cases (86.6%) and after 2 attempts in 4 cases. The foreign body was a headscarf pins in 26 cases, a stone in 2 cases, a vice in one case and a tooth in one case. The immediate result was good in all cases. The purpose of this study was to evaluatethe diagnostic and therapeutic approach to inhalation oftracheobronchial foreign bodies in adults. Conclusions: Tracheobranchial foreign body aspiration is a rare accident in adults, although its prevalence increases with age due to certain predisposing factors. The occurrence of a penetration syndrome, even in the absence of a highly suggestive radioclinical examination, requires endoscopic exploration for diagnostic and therapeutic purposes.