Utility of Flexible Bronchoscopy for Airway Foreign Bodies Removal in Adults

Abstract

Foreign body aspiration is relatively infrequent in adults. Airway foreign bodies (AFBs) can be removed by flexible bronchoscopy (FB) or rigid bronchoscopy (RB). We performed a retrospective analysis of FBs performed in our centre over a 25 year period, focusing on the procedures that revealed an AFB during the examination stage. We recorded demographic data, clinical characteristics and radiological and bronchoscopic findings. During the study period, 12,588 FBs were performed in adults. Airway foreign bodies were identified in 32 of these cases, giving a prevalence of 0.25%. The most frequent clinical presentation was cough, sputum and fever. The most frequent radiological findings were alveolar infiltrates and atelectasis. In 94% of cases, AFBs were removed successfully by FB; RB was necessary in only 6% of cases. There were no FB-related complications. The most common AFB location was the right bronchial tree (69%). We classified AFBs as organic (85%: animal 57%; vegetable 28%), inorganic (6%) and iatrogenic (9%). Bronchial infection occurred in 51% of cases, and Actinomyces spp. was the most common causal microorganism. In conclusion, AFBs are a rare entity with nonspecific clinical presentation, most AFBs were organic, and FB is a safe and effective method for AFB removal.

Occult foreign body aspirations in pediatric patients: 20-years of experience

“…Although fiberoptic bronchoscopy has been advocated by some researchers [16], rigid bronchoscopy is still the gold standard for removing bronchial foreign bodies in children [17,18]. Compared with fiberoptic bronchoscope, removal of FBs under rigid bronchoscope is safer.…”

Adult with mass burnt lime aspiration: A case report and literature review

“…Compared with rigid bronchoscopy, flexible fiberoptic bronchoscopy is a fast, economic and safe procedure that does not require general anesthesia[ 9 ]. At present, rigid bronchoscopy combined with flexible fiberoptic bronchoscopy is also used to remove airway foreign bodies[ 10 ].…”

Empyema associated with vegetable foreign body aspiration

“…Cases of airway foreign bodies (AFBs) are relatively rare in adults; the prevalence of AFBs has been estimated as 0.25% of bronchoscopies. [5] Most patients with AFBs have significant risk factors, including neurological and neuromuscular diseases, drug and alcohol abuse, or a history of head trauma. Swallowing diffi culties and other gastrointestinal tract disorders also increase the risk of AFBs.…”