Flexible bronchoscopy for foreign body aspiration in children: A single-centre experience

Table 1 Summary table of patients and clinical features characterizing foreign body extraction from the tracheobronchial tree

Patient	Age (months)	FB localization	Distal end outer diameter of bronchoscope (mm)	Endoscopic instrument	Type of anaesthesia (LMA/ET)
1	53	Right main bronchus	4.2	Retrieval basket	ET, extraction with extubation
2	13	Left main bronchus	3.1	Tripod type forceps	ET, through the tube
3	41	Right main bronchus	4.2	Alligator jaw forceps	LMA
4	122	Intermediate bronchus	3.1	Rat tooth forceps	ET, extraction with extubation
5	25	Left main bronchus	3.1	Retrieval basket	LMA
6	22	Intermediate bronchus	3.1	Retrieval basket	ET, through the tube
7	136	Right lower lobe bronchus	4.2	N/D	LMA
8	125	Right main bronchus	6.2	Tripod type forceps	LMA
9	16	Left main bronchus	3.1 with switching to 4.2	Rat tooth forceps	LMA
10	42	Intermediate bronchus	6.2	Alligator jaw forceps	LMA
11	25	Right upper lobe bronchus	3.1 with switching to 4.2 mm	Rat tooth forceps + retrieval net	LMA
12	50	Left lower lobe bronchus	3.1	Rat tooth forceps	LMA
13	20	Right lower lobe bronchus	3.1	Retrieval basket	LMA
14	13	Left main bronchus	3.1	N/D	LMA
15	20	Left lower lobe bronchus	3.1	Tripod type forceps + retrieval basket	ET, through the tube
16	43	Right upper lobe + lower lobe bronchi	3.1	Retrieval basket	ET, through the tube
17	18	Right main bronchus	3.1	Tripod type forceps	ET, extraction with extubation
18	128	Right lower lobe bronchus	4.2	Retrieval net	ET, extraction with extubation
19	22	Right lower lobe bronchus	4.2	Tripod type forceps + retrieval basket	ET, through the tube
20	131	Right main bronchus	6.2	N/D	LMA
21	20	Right main bronchus	3.1	Retrieval basket	LMA
22	15	Left main bronchus	3.1	Retrieval basket	LMA
23	9	Right upper lobe bronchus	3.9	Alligator jaw forceps	ET, through the tube
24	12	Right main bronchus	3.1	Snare	ET, extraction with extubation

FB: Foreign body; ET: Endotracheal tube; LMA: Laryngeal mask airway; N/D: No data.

Table 2 Foreign body localization in the tracheobronchial tree (percentage)

Tracheobronchial tree localization	Number of cases	%
Right main bronchus	7	29.2
Left main bronchus	5	20.1
Intermediate bronchus	3	12.5
Right lobar bronchi	7	29.2
Left lobar bronchi	2	8.9

Table 3 Analysis of a foreign body origin and its topography after aspiration

Age (month)	Topography		Origin of foreign body
	Large bronchi	Lobar and segmental bronchi	Organic (%)	Non-organic (%)
0-25	9	5	10 (71.4)	4 (28.6)
40-60	3	2	1 (20)	4 (80)
120-140	3	2	1 (20)	4 (80)

Table 4 Efficacy of flexible bronchoscopy as a first treatment option in foreign body aspiration

Ref.	Number of patients	Efficacy of flexible bronchoscopy alone (%)	Complications (%)
Ding et al[10]	165	97.6 (161/165)	Transient hypoxia and tachypnoea; one severe complication (no specified)
Tenenbaum et al[11]	28	100 (28/28)	No/no specified
Kim et al[16]	20	90 (18/20)	10 (n = 2), mild laryngeal oedema
Yüksel et al[17]	31	93.5 (29/31)	0
Tang et al[22]	1027	91.7 (938/1027)	12.9 (transient hypoxia); 2.3 (bleeding, laryngeal oedema, bradycardia, airway leak)
Golan-Tripto et al[23]	40	95 (38/40)	0
Suzen et al[24]	24	100 (24/24)	8.4 laryngeal oedema
Ciftci et al[25]	283	92 (260/283)	3.5 (transient hypoxia and bradycardia); 3.9 (minor bleeding); 3.9 (minor nosebleed); 2.8 (laryngeal oedema)