Tracheobronchial Foreign Bodies: The Importance of Timely Intervention and Appropriate Collaboration

The aim of study is to determine epidemiological profile of the cases suspected to have laryngotracheobronchial foreign body, average interval between onsets of symptoms and presentation to our tertiary centre, average interval between admission and active surgical intervention, incidence of various clinical, radiological and intraoperative findings. All patients presenting to our institution with suspicion of foreign body inhalation who underwent rigid bronchoscopy from October 2012 to April 2018 were considered for this study. Data compilation of these patients was done which included age, sex, chief complain, time of onset, time of presentation to hospital, time till intervention was undertaken, clinical and radiological findings, nature of foreign body, history of ingestion, intraoperative findings and post-operative recovery. All these aspects were then evaluated. Our study included 89 cases who underwent rigid bronchoscopy under General Anaesthesia. 67.4% were male and 71% were children less than 2 years of age. 36% presented within the first 48 h and 64% of these were managed within 24 h of presentation. Of these 50.6% gave history of foreign body inhalation and cough was the most common presentation in 92.1%. Collapse was the most common radiological finding in 42.7% cases. Lodgement of foreign body was slightly more on right side (45.5%). Most of the foreign bodies were of vegetative nature—84.7%. There was no mortality out of all 89 cases. Although the mortality and complication rate has decreased significantly after the advent of endoscopically assisted bronchoscopy, still attention needs to be given to earlier diagnosis of foreign body aspiration and earlier referral to an ENT surgeon for bronchoscopy if required. Also the time duration between intervention to be undertaken from the time of symptom onset can be decreased with a better collaboration between the Radiologist, the Paediatrician and the Otorhinolaryngologist.