Foreign Body Removal by Flexible Bronchoscopy Using Retrieval Basket in Children

Aim: To evaluate the efficacy and safety of Flexible Bronchoscopy as first-line diagnosis and treatment modality in pediatric cases with Foreign body aspiration (FBA) Methods: We performed a retrospective study reviewing the clinical records of 219 children who underwent flexible bronchoscopy (FB) for suspected FBA, over a period of 26 years. We evaluated the success of FB in removal of foreign body using a retrieval basket at a referral tertiary hospital. Results: FBA was confirmed with bronchoscopy in 104 cases (47.5%), (mean age 3.13, range: 6 months-10 years, 68% males). The majority of the foreign bodies were nuts (52.5%), followed by other food particles (16%) and seeds (8%). The foreign body was located predominantly in the right bronchial tree (56%). The most common clinical signs and symptoms were cough (79.5%), reduced air entry (66.3%) and wheezing (29.4%). The most frequent radiological finding was unilateral hyperinflation (55.8%) followed by opacities (23%) and atelectasis (11.5%). Fifty-eight percent of the foreign bodies were removed with a rigid bronchoscope by ENT; over the last 7 years there has been an increasing trend to remove the inhaled foreign body with a basket through the FB. In 41% of the patients with FBA, foreign bodies were successfully removed during FB. Over the last 5 years, only in two patients, foreign body could not be removed with FB and they underwent rigid bronchoscopy. No serious complications were observed in these cases except cough. Conclusions: Flexible bronchoscopic extraction of a foreign body in the airway using a retrieval basket in children can be performed successfully with minimal complications.