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The Role of Bronchoscopy in Foreign Body Aspiration in Children

Osuji AE and Nwogbo A

Introduction: Foreign body aspiration is an otorhinolaryngological emergency which is relatively common in children due to their anatomical predisposition and poor physiological coordination of the swallowing mechanism. This predisposition is further worsened by their increased tendency to put inanimate objects in the mouth. Foreign bodies lodged in the bronchus, can be removed during rigid or flexible bronchoscopy. However, the advent of telescopic bronchoscopy has improved the outcome of bronchoscopy, due to better visualisation with the aid of the telescope. The aim of this study was to evaluate the outcome of the cases of foreign body aspiration managed with bronchoscopy in the University of Port Harcourt Teaching Hospital, Rivers state, Nigeria. Method: This was a retrospective study of 18 patients with foreign body aspiration who had bronchoscopy over a 5 year period from June 2013 to July 2018 in the University of Port Harcourt Teaching Hospital. Data was retrieved from medical records of operating theatre, Ear, Nose and Throat (ENT) ward, and surgical ward. Age, gender, type of foreign body, and location of foreign body was considered. Results were presented as simple tables and figures, and then analysed. Result: 18 (100%) of them had rigid bronchoscopy, among which 6 (33.3%) had telescopic bronchoscopy. There were 11 males and 7 females. 17 patients were aged < 15 years, and all of them had foreign body in bronchus. Foreign body was lodged in the left bronchus in 10 (58.8%) patients, while in 8 (41.2%) patients it was in the right bronchus. Foreign body retrieval failed in 1 patient, and mortality of 1(5.6%) patient was recorded. The highest rate of bronchoscopy 11(61.1%) was noted in patients within age 1-5 years. Conclusion: Bronchoscopy remains the gold standard for management of foreign body aspiration in which the foreign body is lodged in the bronchus. Telescopic bronchoscopy is encouraged for better visualization during procedure. However, early presentation and accurate diagnosis are key to a good outcome.