Abstract
Objectives: To evaluate the experience with the flexible bronchoscopic management of airway foreign bodies (FB) in children (age £ 16 years).Design: All pediatric bronchoscopies performed in the Pavillon B of Abderrahman Mami Hospital of Ariana from 2002 through 2014 with confirmed FB were reviewed. FB removed by flexible bronchoscope, techniques used and complications were analyzed.Results: Of the 76 children with FB, the flexible bronchoscope allowed FB extraction in 15 children. It was used as first line to extract the FB in 6 patients, in 6 patients in whom the rigid bronchoscopic procedure was unsuccessful and in 3 patients in whom the rigid bronchoscopy failed to visualize the FB. In two children, extraction failed and removal was made by bronchotomy in one case and by rigid bronchoscopy in the other one. FB were non-organic in 8 cases, among them 3 head scarf pins. Flexible bronchoscopy was performed through an endotracheal tube in 14 children under general anesthesia. In the other child, the procedure was accomplished under local anesthesia. The extraction instruments employed included baskets forceps and biopsy forceps.No major complications occurred, only one children developed laryngeal edema that resolved with medical therapy.Conclusions: Flexible bronchoscopic extraction of pediatric FB can be performed safely with minimal risks and complications. In our experience, it was successful in 88% of cases. Nevertheless, we caution that it must be performed by an experienced bronchoscopist in the operating room and in the presence of a trained anesthetist.