Airway Foreign Bodies: A Retrospective Study 10 Years in Maharat Nakhon Ratchasima Hospital

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Munlika Saengwaree

Abstract

Background: Foreign body aspiration (FBA) is an emergency condition in otolaryngologist. It has a susceptible management to diagnosis and treatment that may lead to fatal. The standard of treatment is bronchoscopy that is the high-risk procedure. The patient may be have complications either FB or bronchoscopy. Then close monitor is required post-operation. This study evaluated data of the FBAs and all performed bronchoscopies in Maharat Nakhon Ratchasima Hospital.
Methods: A retrospective descriptive study conducted at Maharat Nakhon Ratchasima Hospital, Thailand. We enrolled patients diagnosed with FBAs with evidence of foreign body detected using direct laryngobronchoscopy at any area from the larynx to bronchus. The data was collected by medical record from October 2008 to September 2018. Descriptive statistics were used to analysis.
Results: During the study period, there were 45 patients that met the study criteria (28 Children 17 Adults). The highest incidence of FBA occurred under 2 years old age 28.9%.The most common symptom was cough55.6%. Decreased breath sound is the most presenting physical examination37.8%. The most common finding in Chest X-ray showed atelectasis26.7%.Plant seed was the most common foreign body in children (10 patients, 35.7%) and food aspiration in adults (5 patients, 29.4%).The right main bronchus was the most common site (27 patients, 60%). Most of the patients didn’t have complication after remove FBs (29 patients, 64.4%). Mortality rate in this study was 7.1% in children and 17.7% in adults due to cardiac arrest at home and prolonged hypoxemia.
Conclusion: FBAs must be aware in children younger than 2 years and elderly. Most foreign bodies are plant seeds and foods. History and Physical examination are still important to diagnosis FBAs due to negative film X-ray. Bronchoscopy should be performed if FBAs are suspected. Prevention and public knowledge are keys to reduce mortality rate.
Keywords: Airway foreign body, aspiration, bronchoscopy, complication

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