Airway foreign bodies (FB): a 10-year review

A retrospective chart review of children who had airway foreign body remove d via direct laryngoscopy and bronchoscopy (DLB) from 1987-1997 was conduct ed in Children's Hospital, Boston. Patient characteristics noted included a ge, sex, and clinical presentation. Pre-operative radiographic findings, re ason for delay in evaluation, DLB findings, length of procedure, reason for repeat DLB, and types of foreign body etc. were recorded. Serious complica tions from aspirated Foreign bodies such as severe airway obstruction and d eath tend to occur in infants and younger children because of their small a irway size. A history compatible with foreign body aspiration dictates diag nostic endoscopy with or without radiologic confirmation. Chest and airway radiographs supplemented by fluoroscopy can increase the ratio of correct a nd early diagnosis. Fluoroscopy should be universally accepted as an initia l diagnostic technique in airway foreign body evaluation. Fluoroscopy is no t a worthwhile investigation if a preceeding chest radiograph suggests the presence of a foreign body. Long-standing airway foreign bodies are associa ted with considerable morbidity, and early diagnosis remains the key to suc cessful and uncomplicated management of foreign body aspiration. Education aimed at increasing diagnostic acumen of the physicians and heightening of public awareness are the most important steps needed to reduce the morbidit y and mortality. Parents should be instructed to abstain from feeding nuts and seeds to young children and to keep small, potentially ingestible objec ts out of their reach. (C) 2000 Elsevier Science Ireland Ltd. All rights re served.