Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2019, Vol. 33 ›› Issue (5): 111-115.doi: 10.6040/j.issn.1673-3770.0.2018.355

• Original Article • Previous Articles     Next Articles

Foreign bodies in the throat and bronchi of children: a report of 221 cases

Weihua CHEN(),Kaiyang ZHANG,Xiaobin ZHENG   

  1. Department of Otorhinolaryngology, Longyan First Hospital of Fujian Medical University, Longyan 364000, Fujian, China
  • Received:2018-08-02 Revised:2019-01-03 Online:2019-09-20 Published:2019-10-15
  • Contact: Weihua CHEN E-mail:cwh0082003@163.com

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Abstract: Objective

To summarize the clinical characteristics, diagnosis, and treatment experience of laryngeal and tracheobronchial foreign body aspiration in children, and improve the approach to diagnosis and treatment of this condition.

Methods

Clinical data of 221 cases of laryngeal and tracheobronchial foreign body aspiration in children were retrospectively analyzed, and the pathogenesis in the patients with respect to age, main clinical symptoms and signs, and diagnostic and treatment considerations were summarized.

 Results

In total, 91.9% of the patients were under three years of age, and the proportion of patients between 13 and 24 months was as high as 61.1%. The main clinical symptom was irritant cough, and the main clinical sign was a lung respiratory murmur or double lung respiratory tone asymmetry. The diagnostic accuracy of lung CT was 100%, and the accuracy of localization was 96.4%. The positive rate of exogenous foreign body removal by rigid bronchoscopy in patients with a history of foreign body inhalation was higher than that in patients without such a history (χ2=22.886，P＜0.001). These patients presented with lower respiratory sounds in one lung or asymmetric respiratory sounds in both lungs more often than those without the manifestations enumerated above（χ2=3.905，P=0.048）.In addition to five patients who underwent surgery under the administration of anesthesia or without anesthesia, the remaining patients had the foreign bodies removed by direct laryngoscopy or rigid bronchoscopy.

 Conclusion

Combined with a history of foreign body inhalation, typical pulmonary signs, and lung CT examination results, laryngeal and tracheobronchial foreign bodies can be accurately diagnosed. The extraction of foreign bodies by direct laryngoscopy or rigid bronchoscopy under general anesthesia is an effective method to treat laryngeal and tracheobronchial foreign body aspirations.

Key words: Foreign body, Respiratory, Child, Treatment outcome

CLC Number: 

  • R768.13

Table 1

Comparison of bronchoscopy and computed tomography in diagnosis of tracheobronchial foreign bodies(n)"

异物位置 支气管镜检查 CT定性诊断 CT定位诊断
左支气管 82 82 82
右支气管 80 80 76
双支气管 5 5 4
气管 41 41 40
声门 4 4 4
气管+左支气管 3 3 3
气管+右支气管 3 3 2
气管+双支气管 2 2 1
合计 220 220 212
准确性（%） 100.0 100.0 96.4

Table 2

Positive rate of exogenous foreign body retention"

检测项目 支气管镜检查（例）

外源性异物存留

阳性率（%）

 χ2 P
阳性 阴性
异物吸入史
阳性 194 3 98.5 22.866 ＜0.001
阴性 19 5 79.2

一肺呼吸音减低或

双肺呼吸音不对称
阳性 169 4 97.7 3.905 0.048
阴性 44 4 91.7
刺激性咳嗽
阳性 210 7 96.8 0.921 0.337
阴性 3 1 75.0
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