Laser-assisted removal of a foreign body in the bronchial system of an infant

Background and Objective: Foreign body aspiration is an important cause of acute respiratory distress in children. Removal by use of rigid tracheobronchoscopy under general anesthesia is usually the treatment of choice, but this technique is sometimes unsuccessful. Thoracotomy in these instances often cannot be avoided. Study Design/Patients and Methods: Case report with review of the literature. The patient was 19 months old with an aspirated foreign body. A Neodym:YAG laser with a special small-size delivery system was inserted into the rigid ''baby'' bronchoscope. The Neodymium:YAG laser with a wavelength of 1,064 nm and a Helium-Neon 630 nn light guide provided an aiming beam to weaken and cut the aspirated chicken bone. Results: The foreign body could be easily removed with a regular biopsy forceps. Conclusion: We discuss a patient in whom laser-assisted rigid tracheobronchoscopy obviated the need for thoracotomy. (C) 1995 Wiley-Liss, Inc.