Role of tracheostomy in the management of foreign body airway obstruction in children

Foreign body aspiration in the airway of children is a life-threatening clinical situation. Endoscopic retrieval alone is successful in the majority of patients. Occasionally, open surgical intervention in the form of tracheostomy, thoracotomy and bronchotomy and/or pulmonary resection is needed. We...

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Bibliographic Details
Published in:Singapore medical journal 2009-09, Vol.50 (9), p.871-874
Main Authors: SINGH, J. K, VASUDEVAN, V, BHARADWAJ, N, NARASIMHAN, K. L
Format: Article
Language:English
Subjects:
Airway Obstruction - surgery
Airway Obstruction - therapy
Biological and medical sciences
Bronchoscopy
Bronchoscopy - methods
Child
Child, Preschool
Chronic obstructive pulmonary disease, asthma
Endoscopy
Endoscopy - methods
Female
Foreign Bodies - surgery
General aspects
Humans
Infant
Investigative techniques, diagnostic techniques (general aspects)
Male
Medical sciences
Pneumology
Tracheostomy - methods
Treatment Outcome
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Summary:Foreign body aspiration in the airway of children is a life-threatening clinical situation. Endoscopic retrieval alone is successful in the majority of patients. Occasionally, open surgical intervention in the form of tracheostomy, thoracotomy and bronchotomy and/or pulmonary resection is needed. We analysed the specific indications for tracheostomy during the removal of airway foreign bodies in our study. The records of four patients who needed tracheostomy, out of 342 cases of foreign body airway obstruction managed by the senior author, were analysed. These patients underwent an additional tracheostomy for open removal of the foreign body and/or to secure the airway to facilitate the foreign body removal. Rigid bronchoscopy was successful in retrieving the foreign bodies in 338 (98.8 percent) cases, while four (1.2 percent) cases required additional tracheostomy, either to protect the airway during the procedure or to assist in removing the foreign body. The indications for tracheostomy were subglottic foreign bodies of long duration, sharp subglottic foreign bodies and foreign bodies that were larger than the glottic chink. There was no mortality or long-term complication because of the tracheostomies. Tracheostomy is occasionally indicated in foreign body extraction, when they are subglottic in location and impacted, or are large foreign bodies that get obstructed at the glottic chink during removal.
ISSN:0037-5675