Removal of Tracheobronchial Foreign Bodies in 244 Central South Chinese Adults Using Flexible Bronchoscopy: Experience during 1997-2012_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

LiYing , HuChengping , XiaoQiming , CaoLiming , SuXiaoli , PanPinhua , CaiXiaoling ,  YangHuaping

The Respiratory Department of Xiangya Hospital, Central South University, Changsha, Hu'nan, 410008, China;

Corresponding author：

YangHuaping, Email: liying971@sina.com

Keywords：

Tracheobronchial foreign body; Flexible bronchoscopy; Hot pepper

DOI：

10.7507/1671-6205.2014017

Video：

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Objective Tracheobronchial foreign bodies (TFBs) aspiration is rare in adults,although it can occur at any age. This study aimed to report our experience in airway foreign body removal by flexible bronchoscopy in adult patients of central south China. Methods A total of 244 patients with TFBs over the age of 14 years were reviewed retrospectively from January 1997 to February 2012. The incidence,risk factors,clinical manifestations,radiological findings,types and locations of TFBs were analyzed. Results Among the 27719 patients,TFBs were found only in 0.88%(244) cases. The prevalence of TFB aspiration increased steadily with age beginning in the fifth decade. The incidence of TFBs was 0.62% among people aged 70 to 80 years. Risk factors such as cerebrovascular diseases and neural degenerative disease were found among 32 (6.6%) patients. Among 153 patients with clear history of foreign body aspiration,135 patients (88.2%) were addicted to the hot pepper. Paroxysmal cough (81.1%) was the most common clinical manifestations of TFBs. Only 12 cases (4.9%) were found with non-opaque foreign bodies by chest X-ray but 106 cases (43.4%) were found with opaque foreign bodies by chest CT. The most common indirect chest imaging findings were recurrent infections and consolidation of the same area.Bone fragments of animals was the most common type in foreign bodies (47.2%). The most common position of foreign bodies was the right bronchial (65.6%). Total foreign bodies of 234 patients (95.9%) had been successfully removed by flexible bronchoscopy. Conclusion Although TFBs is rare in adults in south China,but yield by flexible bronchoscopy (0.88%) is much higher than that is reported in western countries (0.32%-0.33%). Addiction to the hot pepper and speaking loudly when having dinner may be the major risk factor for high incidence in central south China.

Citation： LiYing, HuChengping, XiaoQiming, CaoLiming, SuXiaoli, PanPinhua, CaiXiaoling, YangHuaping. Removal of Tracheobronchial Foreign Bodies in 244 Central South Chinese Adults Using Flexible Bronchoscopy: Experience during 1997-2012. Chinese Journal of Respiratory and Critical Care Medicine, 2014, 13(1): 72-77. doi: 10.7507/1671-6205.2014017 Copy

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2.	Pan H,Lu Y,Shi L,et al.Similarities and differences in aspirated tracheobronchial foreign bodies in patients under the age of 3 years. Int J Pediatr Otorhinolaryngol,2012,76:911-914.
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7.	Lan RS.Non-asphyxiating tracheobronchial foreign bodies in adults.Eur Respir J,1994,7:510-514.
8.	Brooks SM.Perspective on the human cough reflex. Cough,2011,7:10.
9.	Pinto A,Scaglione M,Pinto F,et al.Tracheobronchial aspiration of foreign bodies:current indications for emergency plain chest radiography.Radiol Med,2006,111:497-506.
10.	Pinto A,Scaglione M,Pinto F,et al.Tracheobronchial aspiration of foreign bodies:current indications for emergency plain chest radiography.Radiol Med (Torino),2006,111:497-506.
11.	Prakash UB,Midthun DE,Edell ES,et al.Indications for flexible versus rigid bronchoscopy in children with suspected foreign-body aspiration.Am J Repir Crit Care Med,1997,156:1017-1019.
12.	Zaytoun GM,Rouadi PW,Baki DH.Endoscopic management of foreign bodies in the tracheobronchial tree:predictive factors for complications.Otolaryngol Head Neck Surg,2000,123:311-316.

1. Zhijun C,Fugao Z,Niankai Z,et al.Therapeutic experience from 1428 patients with pediatric tracheobronchial foreign body.J Pediatr Surg,2008,43:718-721.
2. Pan H,Lu Y,Shi L,et al.Similarities and differences in aspirated tracheobronchial foreign bodies in patients under the age of 3 years. Int J Pediatr Otorhinolaryngol,2012,76:911-914.
3. Boyd M,Chatterjee A,Chiles C,et al.Tracheobronchial foreign body aspiration in adults. South Med J,2009,102:171-174.
4. Mise K,Jurcev Savicevic A,Pavlov N,et al.Removal of tracheobronchial foreign bodies in adults using flexible bronchoscopy:experience 1995-2006. Surg Endosc,2009,23:1360-1364.
5. Ramos MB,Fernández-Villar A,Rivo JE,et al.Extraction of airway foreign bodies in adults:experience from 1987-2008. Interact Cardiovasc Thorac Surg,2009,9:402-405.
6. Debeljak A,Sorli J,Music E,et al.Bronchoscopic removal of foreign bodies in adults:experience with 62 patients from 1974-1998.Eur Respir J,1999,14:792-795.
7. Lan RS.Non-asphyxiating tracheobronchial foreign bodies in adults.Eur Respir J,1994,7:510-514.
8. Brooks SM.Perspective on the human cough reflex. Cough,2011,7:10.
9. Pinto A,Scaglione M,Pinto F,et al.Tracheobronchial aspiration of foreign bodies:current indications for emergency plain chest radiography.Radiol Med,2006,111:497-506.
10. Pinto A,Scaglione M,Pinto F,et al.Tracheobronchial aspiration of foreign bodies:current indications for emergency plain chest radiography.Radiol Med (Torino),2006,111:497-506.
11. Prakash UB,Midthun DE,Edell ES,et al.Indications for flexible versus rigid bronchoscopy in children with suspected foreign-body aspiration.Am J Repir Crit Care Med,1997,156:1017-1019.
12. Zaytoun GM,Rouadi PW,Baki DH.Endoscopic management of foreign bodies in the tracheobronchial tree:predictive factors for complications.Otolaryngol Head Neck Surg,2000,123:311-316.

Chinese Journal of Respiratory and Critical Care Medicine

Removal of Tracheobronchial Foreign Bodies in 244 Central South Chinese Adults Using Flexible Bronchoscopy: Experience during 1997-2012

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