Use of Fiberoptic Bronchoscopy to Retrieve Bronchial Foreign Bodies in Adults

Abstract

The flexible fiberoptic bronchoscope was used to treat bronchial foreign bodies in 33 adults. The length of time that the foreign body was in the lung was less than 1 wk in six (acute group), more than 1 month in 21 (chronic group), and uncertain in two (uncertain group), and the foreign body was an endogenous broncholith in four patients (broncholith group). The foreign bodies were nonfragile, solid matter in most cases and they frequently had sharp projections on them. Granulations around the foreign body were common in the chronic group, but there was no correlation between the length of time the foreign body was in the lung and the amount of granulation or the number of the bronchoscopies needed for diagnosis or management. The granulations did not bleed easily on biopsy or during removal of the foreign body. In fact, they receded if several pieces were removed, making the foreign body much easier to recognize and to retrieve in the next bronchoscopy (about 1 wk later). After removal of the foreign body, the residual granulations regressed, and the bronchial lumen became more patent. The mortality, morbidity, and complication rates were very low, whereas the success rate was high. We conclude that flexible fiberoptic bronchoscopy is practical and safe in retrieving bronchial foreign bodies in adult patients.

Non-asphyxiating tracheobronchial foreign bodies in adults

“…The result was much better than in that experienced by LIMPER and PRAKASH [8], and could have reached the success rate of rigid open tube bronchoscopy if the duration of the foreign body in the airway was considered. The improved and modified technique for retrieving foreign bodies has been published in detail elsewhere [27].…”

What The Tooth Fairy Missed: An Unusual Cause of Recurrent Pneumonia and Successful Management with Fiberoptic Bronchoscopy

“…Symptoms that have been most commonly reported include chronic cough and wheeze, recurrent pneumonia and haemoptysis [1][2][3]. Lan et al, reported that 70% of their patients were chronic (defined as presence of the foreign bodies in the airways for more than one month prior to removal), with a mean duration was 20.6 months [8]. In a CxR, the diagnosis and localization of opaque foreign bodies is more straightforward compared to organic foreign bodies which tend to be radiolucent and hence does not show up on CxR.…”

Role of Flexible-Bronchoscopy in Pulmonary and Critical Care Practice

“…Overall success rates for retrieval of FBs ranges from 61 to 89% for both flexible and rigid bronchoscopies. (Limper &Prakash, 1990;Debeljak et al, 1999;Cunanan, 1978;Lan et al, 1989) FFB is probably more useful for FB in distal segments beyond the reach of rigid bronchoscope. In some cases, flexible and rigid bronchoscopy are complementary, with FFB assisting in the localization of the FB and then retrieval done with the rigid bronchoscope.…”