TRACHEOBRONCHIAL FOREIGN-BODIES IN ADULTS

Study Objective: To define the clinical spectrum of tracheobronchial foreign body aspiration in adults, assess predisposing conditions, evaluate the efficacy of bronchoscopy, and determine outcome and complications. Design: Retrospective analysis of a consecutive clinical series. Setting: A tertiary care, referral-based medical center. Patients: Sixty consecutive adult patients (over 16 years of age) evaluated for tracheobronchial foreign body aspiration. Interventions: All 60 patients had bronchoscopic evaluation; 59 of them had foreign bodies identified and removal was attempted using either rigid or flexible fiberoptic bronchoscopy. Main Results: Of 60 consecutive patients, 25 had underlying impairment of protective airway mechanisms (primary neurologic disorders, trauma with loss of consciousness, or sedative or alcohol use). Fifty-seven were successfully managed with bronchoscopy. Fiberoptic bronchoscopy was successful in 14 of 23 patients, and rigid bronchoscopy was successful in 43 of 44 patients, including 6 of 7 patients in whom previous fiberoptic bronchoscopy had failed. Thoracotomy was required in 3 patients. Complications of bronchoscopy were rare and not serious. Chronic complications of prolonged foreign body impaction included bronchiectasis in 3 patients.