Open Access“Stuck”: Removal of Embedded Distal Airway Foreign Bodies
Author(s) -
Hoff Stephen
Publication year - 2012
Publication title -
otolaryngology–head and neck surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.232
H-Index - 121
eISSN - 1097-6817
pISSN - 0194-5998
DOI - 10.1177/0194599812451426a322
Subject(s) - medicine , airway , foreign body , forceps , granulation tissue , bronchoscopy , foreign bodies , balloon dilation , surgery , balloon catheter , balloon , catheter , respiratory distress , anesthesia , wound healing
Objective 1) Describe a novel technique for removal of embedded distal airway foreign bodies. 2) Apply the proximal endoscopic balloon dilation technique for removal of embedded distal airway foreign bodies in 2 patients. 3) Discuss the evolution, operative considerations, and future applications of the technique Method Report of 2 cases in 2011. Condition studied: Embedded, symptomatic distal airway foreign bodies. Subjects studied: Pediatric airway patients. Setting: Tertiary care pediatric hospital. Intervention: Rigid bronchoscopy with endoscopic balloon dilation of the proximal bronchial segment to facilitate access to the foreign body. Outcomes: Successful foreign body removal. Results Case 1: A 23‐month‐old patient with recurrent pneumonia. Rigid bronchoscopy showed a cashew piece in the distal airway with proximal edema preventing removal. Dilation of the proximal bronchial segment with a Fogarty catheter allowed for access and removal with optical forceps. Case 2: Two‐year‐old unrestrained passenger in a motor vehicle accident with tooth aspiration causing intermittent respiratory distress. At bronchoscopy, the tooth was in the distal airway and embedded in granulation tissue which prevented removal. A Fogarty catheter was used to dilate the bronchial segment proximal to the foreign body which was then removed with optical forceps. Conclusion Embedded airway foreign bodies are associated with edema and granulation tissue which may prevent removal due to proximal airway narrowing. We present a novel technique using a Fogarty balloon catheter to dilate the airway proximal to the foreign body. This allows for removal of otherwise stuck distal airway foreign bodies.