Effect of tracheobronchial foreign body removal using flexible bronchoscopy in adult
H. Kima (Dr), JH. Jeongb (Dr), HJ. Parkc (Dr), CM. Choic (Prof), TS. Shimc (Prof), W. Ji*c (Prof)
a Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul, KOREA, REPUBLIC OF ; b Division of Pulmonology and Allergy, Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, KOREA, REPUBLIC OF ; c Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KOREA, REPUBLIC OF
Background: Although tracheobronchial foreign body (FB) aspiration is life-threatening condition, there are a few studies on the effectiveness of bronchoscopic treatment in adults. The aim of this study was to evaluate the clinical characteristics, outcomes of flexible bronchoscopic FBs removal in adults
Methods: In this retrospective study, we collected medical records of patients diagnosed airway FB aspiration at Asan Medical Center, South Korea, from January 2003 to December 2020.
Results: A total number of enrolled patients who underwent flexible bronchoscopic FB was 68. The median age of the patients was 65 years, 85% was males. All of the patients received flexible bronchoscopy and 94% of patients successfully removed FB (62/66). 4 patients who failed FB removal by flexible bronchoscopy were rescued by rigid bronchoscopy. Neurologic disease with dysphagia was the most common underlying comorbidities (26.5%); artificial teeth and dental device were the most common aspirated FB (38.2%). It showed a tendency to aspirate better into the right (43/68, 63.2%) than the left bronchus (23/68, 33.8%, p=0.056). The success rate of FB removal within 4 weeks was higher than those after 4 weeks (P=0.005).
Conclusion: Flexible bronchoscopy is useful procedure to remove tracheobronchial FB and bronchoscopic removal delayed more than 4 weeks after aspiration had a high possibility of technical failure. Furthermore, aspiration of FB in tracheobronchial tree appeared to be prevalent in the patients who had neurologic disease or underwent dental procedure.
Disclosure of funding source(s): none