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Flexible bronchoscopy with multiple modalities for foreign body removal in adults.

Fang YF, Hsieh MH, Chung FT, Huang YK, Chen GY, Lin SM, Lin HC, Wang CH, Kuo HP - PLoS ONE (2015)

Bottom Line: More patients with chronic aspiration than those with acute aspiration were referred from the out-patient clinic (48% vs. 28%), but more patients with acute aspiration were referred from the emergency room (35% vs. 6%) and intensive care unit (18% vs. 2%).Electromagnet or cryotherapy was used in nine patients to eliminate the surrounding granulation tissue before foreign body removal.Flexible bronchoscopy with multiple modalities is effective for diagnosing and removing foreign bodies in the lower respiratory airways in adults, with a high success rate (90%) and no difference between acute and chronic aspirations.

View Article: PubMed Central - PubMed

Affiliation: Department of Thoracic Medicine, Chang Gung Foundation, Chang Gung Memorial Hospital, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.

ABSTRACT

Objectives: Aspiration of the lower airways due to foreign body is rare in adults. This study aimed to determine the outcome of patients who received flexible bronchoscopy with different modalities for foreign body removal in the lower airways.

Patients and methods: Between January 2003 and January 2014, 94 patients diagnosed with foreign body in the lower airways underwent flexible bronchoscopy with different modalities, which included forceps, loop, basket, knife, electromagnet, and cryotherapy. The clinical presentation, foreign body location and characteristics, and applications of flexible bronchoscopy were analyzed.

Results: Forty (43%) patients had acute aspiration, which developed within one week of foreign body entry and 54 (57%) had chronic aspiration. The most common foreign bodies were teeth or bone. More patients with chronic aspiration than those with acute aspiration were referred from the out-patient clinic (48% vs. 28%), but more patients with acute aspiration were referred from the emergency room (35% vs. 6%) and intensive care unit (18% vs. 2%). Flexible bronchoscopy with different modalities was used to remove the foreign bodies (85/94, 90%). Electromagnet or cryotherapy was used in nine patients to eliminate the surrounding granulation tissue before foreign body removal. In the nine patients with failed flexible bronchoscopy, eight underwent rigid bronchoscopy instead and one had right lower lung lobectomy for lung abscess.

Conclusions: Flexible bronchoscopy with multiple modalities is effective for diagnosing and removing foreign bodies in the lower respiratory airways in adults, with a high success rate (90%) and no difference between acute and chronic aspirations.

No MeSH data available.


Related in: MedlinePlus

(A) Atelectasis of the right lower lung. (B) Foreign body in the right intermediate bronchus. (C) Granulation tissue covered the foreign body. (D) Bony foreign body after removing the granulation tissue by cryotherapy and forceps. (E) A patent right intermediate bronchus is noted after foreign body removal. (F) The foreign body.
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pone.0118993.g002: (A) Atelectasis of the right lower lung. (B) Foreign body in the right intermediate bronchus. (C) Granulation tissue covered the foreign body. (D) Bony foreign body after removing the granulation tissue by cryotherapy and forceps. (E) A patent right intermediate bronchus is noted after foreign body removal. (F) The foreign body.

Mentions: Forty-three patients had granulation tissue, including nine who needed electromagnet or cryotherapy to remove the granulation tissue that partially or totally covered the foreign bodies (Fig. 2A and 2B). Electromagnet or cryotherapy was done for the granulation tissue or masses in the lower airway (Fig. 2C). The foreign body was removed after removal of the granulation tissue (Fig. 2D), which revealed a patent bronchial lumen (Fig. 2E and 2F).


Flexible bronchoscopy with multiple modalities for foreign body removal in adults.

Fang YF, Hsieh MH, Chung FT, Huang YK, Chen GY, Lin SM, Lin HC, Wang CH, Kuo HP - PLoS ONE (2015)

(A) Atelectasis of the right lower lung. (B) Foreign body in the right intermediate bronchus. (C) Granulation tissue covered the foreign body. (D) Bony foreign body after removing the granulation tissue by cryotherapy and forceps. (E) A patent right intermediate bronchus is noted after foreign body removal. (F) The foreign body.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4358882&req=5

pone.0118993.g002: (A) Atelectasis of the right lower lung. (B) Foreign body in the right intermediate bronchus. (C) Granulation tissue covered the foreign body. (D) Bony foreign body after removing the granulation tissue by cryotherapy and forceps. (E) A patent right intermediate bronchus is noted after foreign body removal. (F) The foreign body.
Mentions: Forty-three patients had granulation tissue, including nine who needed electromagnet or cryotherapy to remove the granulation tissue that partially or totally covered the foreign bodies (Fig. 2A and 2B). Electromagnet or cryotherapy was done for the granulation tissue or masses in the lower airway (Fig. 2C). The foreign body was removed after removal of the granulation tissue (Fig. 2D), which revealed a patent bronchial lumen (Fig. 2E and 2F).

Bottom Line: More patients with chronic aspiration than those with acute aspiration were referred from the out-patient clinic (48% vs. 28%), but more patients with acute aspiration were referred from the emergency room (35% vs. 6%) and intensive care unit (18% vs. 2%).Electromagnet or cryotherapy was used in nine patients to eliminate the surrounding granulation tissue before foreign body removal.Flexible bronchoscopy with multiple modalities is effective for diagnosing and removing foreign bodies in the lower respiratory airways in adults, with a high success rate (90%) and no difference between acute and chronic aspirations.

View Article: PubMed Central - PubMed

Affiliation: Department of Thoracic Medicine, Chang Gung Foundation, Chang Gung Memorial Hospital, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.

ABSTRACT

Objectives: Aspiration of the lower airways due to foreign body is rare in adults. This study aimed to determine the outcome of patients who received flexible bronchoscopy with different modalities for foreign body removal in the lower airways.

Patients and methods: Between January 2003 and January 2014, 94 patients diagnosed with foreign body in the lower airways underwent flexible bronchoscopy with different modalities, which included forceps, loop, basket, knife, electromagnet, and cryotherapy. The clinical presentation, foreign body location and characteristics, and applications of flexible bronchoscopy were analyzed.

Results: Forty (43%) patients had acute aspiration, which developed within one week of foreign body entry and 54 (57%) had chronic aspiration. The most common foreign bodies were teeth or bone. More patients with chronic aspiration than those with acute aspiration were referred from the out-patient clinic (48% vs. 28%), but more patients with acute aspiration were referred from the emergency room (35% vs. 6%) and intensive care unit (18% vs. 2%). Flexible bronchoscopy with different modalities was used to remove the foreign bodies (85/94, 90%). Electromagnet or cryotherapy was used in nine patients to eliminate the surrounding granulation tissue before foreign body removal. In the nine patients with failed flexible bronchoscopy, eight underwent rigid bronchoscopy instead and one had right lower lung lobectomy for lung abscess.

Conclusions: Flexible bronchoscopy with multiple modalities is effective for diagnosing and removing foreign bodies in the lower respiratory airways in adults, with a high success rate (90%) and no difference between acute and chronic aspirations.

No MeSH data available.


Related in: MedlinePlus