Shahzad Hussain Qadri, Aneesur Rehman.
Foreign bodies in tracheobronchial tree: a three year experience in a tertiary care health centre.
J Sheikh Zayed Med Coll Jan ;1(3):78-81.

Background: Aspiration of foreign bodies (FB) in tracheobronchial tree remains a continuous challenge to otorhinolaryngologists, major issues being their accurate diagnosis and timely as well as safe removal. Diagnostic and therapeutic bronchoscopy remains the gold standard in their management. Objective: The objective of this study was to identify clinical & demographic features of the patients, types of foreign bodies and the use of rigid bronchoscopy in their management. Patients and Methods. This was a three year descriptive study, carried out in the Department of Otorhinolaryngology, Sheikh Zayed Hospital, Rahim Yar Khan, from 1st January 2007 to 31st December 2009. All patients underwent physical and radiological assessment and those with the highest level of suspicion of having foreign bodies in tracheobronchial tree, underwent diagnostic and therapeutic bronchoscopy. Results: Rigid bronchoscopy was done in sixty six patients, of which 52 (78 %) were male. Fifty two out of sixty two (82%) patients were less than five years of age. Forty two patients were admitted within twenty four hours after aspiration. The most common clinical findings were prolonged expiration (42%), reduced air entry on affected side (24%), sternal retraction (20%), abnormal auscultation (40%), wheezing (62%) and fever (58%). FBs were found in 62 (94% ) patients. 42(68%) had FBs in right bronchi and 20 (32%) in left bronchi. Beetle nuts (39%) and peanuts (24%) were the most common FBs. Conclusion: Patients especially children, with resistant or recurrent lower respiratory tract infections and those with high degree of suspicion must undergo bronchoscopic evaluation. Rigid bronchoscopy is a very effective procedure to safely remove FBs from proximal divisions of main bronchi.

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