Flexible Bronchoscopy with Multiple Modalities for Foreign Body Removal in Adults |
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Authors: | Yueh-Fu Fang Meng-Heng Hsieh Fu-Tsai Chung Yao-Kuang Huang Guan-Yuan Chen Shu-Min Lin Horng-Chyuan Lin Chin-Hwa Wang Han-Pin Kuo |
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Affiliation: | 1. Department of Thoracic Medicine, Chang Gung Foundation, Chang Gung Memorial Hospital, Taoyuan, Taiwan.; 2. College of Medicine, Chang Gung University, Taoyuan, Taiwan.; 3. Division of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital, Chia-Yi, Taiwan.; Oregon Health and Science University, UNITED STATES, |
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Abstract: | ObjectivesAspiration of the lower airways due to foreign body is rare in adults. This study aimed to determine the outcome of patients who received flexible bronchoscopy with different modalities for foreign body removal in the lower airways.Patients and MethodsBetween January 2003 and January 2014, 94 patients diagnosed with foreign body in the lower airways underwent flexible bronchoscopy with different modalities, which included forceps, loop, basket, knife, electromagnet, and cryotherapy. The clinical presentation, foreign body location and characteristics, and applications of flexible bronchoscopy were analyzed.ResultsForty (43%) patients had acute aspiration, which developed within one week of foreign body entry and 54 (57%) had chronic aspiration. The most common foreign bodies were teeth or bone. More patients with chronic aspiration than those with acute aspiration were referred from the out-patient clinic (48% vs. 28%), but more patients with acute aspiration were referred from the emergency room (35% vs. 6%) and intensive care unit (18% vs. 2%). Flexible bronchoscopy with different modalities was used to remove the foreign bodies (85/94, 90%). Electromagnet or cryotherapy was used in nine patients to eliminate the surrounding granulation tissue before foreign body removal. In the nine patients with failed flexible bronchoscopy, eight underwent rigid bronchoscopy instead and one had right lower lung lobectomy for lung abscess.ConclusionsFlexible bronchoscopy with multiple modalities is effective for diagnosing and removing foreign bodies in the lower respiratory airways in adults, with a high success rate (90%) and no difference between acute and chronic aspirations. |
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