• Korean Journal of Bronchoesophagology
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• v.2 no.2
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• pp.238-243
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• 1996

Aspiration of foreign bodies into the tracheobronchial tree is unusual in adults and it may result in Proximal airway obstruction and acute life-threatening asphyxia. It can be diagnosed by history of aspiration or visualizing the foreign body by chest roentgenogram or bronchoscopy. But it is rarely considered in adults with subacute or chronic respiratory symptoms without a definite history which suggests an aspiration. A 70-year-old woman was admitted to the hospital due to productive cough for two months and dyspnea which aggravated since the day before admission. Chest X-ray showed Pneumonic infiltration on left upper lobe and right lower lobe. Despite several days of conventional therapy, the patient complained of severe dyspnea and wheezing. We performed chest CT to rule out endobronchial stenosis, and it revealed the narrowing of left main stem bronchus compatible with endobronchial tuberculosis. Fiberoptic bronchoscopy for confirmation disclosed a $3.2{\times}0.7{\times}0.2$cm sized foreign body located longitudinally at the left main stem bronchus. We removed it with alligator forcep and it proved In be a piece of artificial denture. The patient remembered losing it while severe coughing on the day before admission. The microscopic examination of bronchial washing fluid revealed numerous acid fast bacilli. After removal of the foreign body, the patient showed marked improvement in symptom and pulmonary function test. Here we report a case of Pulmonary aspiration of foreign body which is confused with endobronchial tuberculosis with a review of the literature.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1979.05a
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• pp.8.2-8
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• 1979

Acute obstruction of the upper airway from trachea, a foreign body or Iaryngospasm may lead to death in a few minutes. The immediate restoration of an adequate airway in these patients may be lifesaving. Spontaneous respiration by means of a needle inserted into the trachea was studied in 21 rabbits using 16, 18, and 20 gauge extrcatheters. The results are as follows; 1) Airway resistance was markedly increased in all experimental animals. consequently tidal volume was also significantly decreased, but this seems to be compensatory by increased of respiratory frequency in l6G group. 2) Blood gas analysis revealed adequate pulmonary ventilation through the constricted airway (about 1/3 of normal sized trachea) during 60 minutes. In the other hand, hypercarbia, hypoxemia, and metabolic acidosis were developed in the group with severe constriction of the upper airway (about 1/4-1/6 of normal sized trachea). 3) The further study is postulated to confirm the the possibility of application of needle trcheostomy in man, but the rabbits were tolerable to the constricted airway with a small sized needle (l6G) into the trachea for 60 minutes.

• Tuberculosis and Respiratory Diseases
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• v.40 no.4
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• pp.442-448
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• 1993

Foreign body aspiration, although not an uncommon problem in children, is unusual in adults and is overlooked as a cause of airway obstruction. Small foreign bodies that lodge in the peripheral airway are often asymptomatic initially and can result in respiratory symptoms several years later. Especially in the cases of otherwise healthy subjects, even though manifested overt respiratory symptoms, diagnosis can be delayed due to lack of history of aspiration or unnoticed aspiration. A 57-year-old male was admitted to Yonsei University College of Medicine Severance hospital due to left upper chest pain for five months. on the past history he had been diagnosed as bronchiectasis about 20 years ago. He showed radiologically bead-like bronchostenosis and a calcific density protruding into the lumen of left upper lobar bronchus. Bronchoscopically broncholith was revealed with the finding of endobronchial obstruction of each upper and lingular division of left upper lobar bronchus due to mucoid impaction and surrounding inflammed bronchial mucosa. The preoperative diagnosis was broncholithiasis due to chronic inflammatory process. Lung perfusion scan shows absence of perfusion in left upper lobe. So left upper lobectomy was performed. But from the pathologic specimen an incisor tooth was emerged. Later a history of tooth extraction thirty years ago at dental clinic was found. We report a case of bronchial obstruction due to occult aspiration of a tooth with a review of the literatures.

• Tuberculosis and Respiratory Diseases
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• v.72 no.6
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• pp.486-492
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• 2012

Background: The aim of this study was to analyze clinical situations requiring rigid bronchoscopy and evaluate usefulness of rigid bronchoscopic intervention in benign or malignant airway disorders. Methods: We retrospectively reviewed 29 patients who underwent rigid bronchoscopy from November 2007 to February 2011 at St. Paul's Hospital, The Catholic University of Korea School of Medicine. Results: Of the 29 patients, the most frequent underlying etiology was benign stenosis of trachea (n=20). Of those 20 patients, 16 had post-intubation tracheal stenosis (PITS), 2 had tracheal stenosis due to inhalation burn (IBTS) and other 2 had obstructive fibrinous tracheal pseudomembrane (OFTP). Other etiologies were airway malignancy (n=6), endobronchial stenosis due to tuberculosis (n=2), and foreign body (n=1). For treatment, silicone stent insertion was done in 16 cases of PITS and IBTS and mechanical removal was performed in 2 cases of OFTP. In 6 cases of malignant airway obstruction mechanical debulking was performed and silicone stents were inserted additionally in 2 cases. Balloon dilatation and electrocautery were used in 2 cases of endobronchial stenosis due to tuberculosis. In all cases of stent, airway obstructive symptom improved immediately. Granulation tissue formation was the most common complication. Conclusion: Tracheal stenosis was most common indication and silicone stenting was most common procedure of rigid bronchoscopy in our center. Rigid bronchoscopic procedures, at least tracheal silicone stenting, should be included in pulmonary medicine fellowship programs because it is a very effective and indispensable method to relieve critical airway obstruction which needs training to learn.

• Tuberculosis and Respiratory Diseases
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• v.57 no.5
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• pp.484-488
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• 2004

In adults, aspiration of foreign bodies into tracheobronchus is sometimes presented atypically, mimicking chronic pulmonary diseases such as bronchial asthma, pneumonia, or empyema, especially without notice of aspiration or choking. In such cases, diagnosis and adequate treatments are often delayed. Suspicion of foreign body aspiration and computed tomography and bronchoscopic examination make correct diagnosis more early. We report a case of bronchial foreign body, which had been misdiagnosed as bronchial asthma with wheezing in the whole lung filed, and reversible airway obstruction in the spirometry.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.23 no.5
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• pp.447-451
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• 2001

With the exception of gun shot wound, the incidence of penetrating injury of face and neck areas nonorganic foreign bodies is relative low. But the diagnostic evaluation and therapeutic management of penetrating facial wounds need careful decision, when the anatomic proximity of the major vessels and nerve is considered. Penetrating facial trauma with concomitant vascular injury present challenging problems, the immediate complication of this vascular injury are severe bleeding, hematoma formation, shock, obstruction of airway. The vascular injury is conformed by angiography. In this report, a industrial tool(long tack) fired by explosive air is penetrated into face and to neck. In angiograms penetrating injury of the vertebral artery is detected. We performed the embolization of the vertebral artery with coils and manual removal of the foreign body without any complication was followed.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.17 no.1
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• pp.49-52
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• 2006

Background and Objectives: Vocal cord granuloma is a exophytic inflammatory mass and caused by gastroesophageal reflux, voice abuse, endotracheal intubation. There has been a controversy in the treatment of vocal cord granuloma. Our aim of study is to know the clinical characteristics and the results of surgical management for vocal cord granuloma. Materials and Methods: We have reviewed and analyzed medical records of 55 patients who were diagnosed and surgically treated as vocal cord granuloma in Asan medical center from 1997 to 2005 retrospectively. Results: 25 cases were intubation granuloma and 30 cases were contact granuloma. In intubation granuloma, the clinical manifestation was hoarseness(70%), foreign body sensation(44%), chronic cough(21%). In contact granuloma, the clinical manifestation was hoarseness(67%), foreign body sensation(60%), throat clearing(21%). The recurrence rate after surgery was 8% in intubation granuloma and 33% in contact granuloma. Mean recurrence time was 4.1months in intubation granuloma and 3.2months in contact granuloma. Conclusion: Although there is no significant difference, recurrence rate after surgery was high in contact granuloma compared to intubation granuloma(p=0.125). Although this study is retrospective, surgical management must be considered in resolving diagnostic doubt, treating airway obstruction, and failure in conservative treatments.

• Sleep Medicine and Psychophysiology
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• v.12 no.1
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• pp.64-67
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• 2005

Obstructive sleep apnea syndrome(OSAS) is a common disease in the field of otorhinolaryngology and is characterized by repeated upper airway occlusions occurring during sleep. OSAS can occur due to various etiologies of the nasal, oral, pharyngeal and laryngeal airway in adults. Nasal obstruction can be caused by septal deviation, nasal polyps, concha bullosa, choanal atresia, neoplasms, foreign body, postoperative/post-traumatic synechiae, various rhinitis and so on. There are various kinds of surgical treatment of OSAS including nasal surgery, LAUP, UPPP, surgery of tongue base, tracheostomy and so on, but the effect of nasal surgery on snoring and OSAS is controversial. The authors report the case of a patient who had experienced nasal obstruction, moderate snoring and OSAS and who improved after septoplasty and turbinoplasty.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.27 no.2
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• pp.130-133
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• 2016

Rheumatoid arthritis (RA) is a connective tissue disease involving the larynx in 30 % of the patients. Foreign body sensation, hoarseness, and cough are common symptoms in laryngeal involvement. An urgent tracheostomy is required when acute airway obstruction occurs in case of bilateral vocal fold paralysis. The most common cause of bilateral vocal fold paralysis in RA patients is a cricoarytenoid joint arthritis. Laryngeal nerve degeneration is rare cause of bilateral vocal fold paralysis in RA patients. In this case report, an emergent tracheostomy was performed on a 64-years-old male patient with acute dyspnea, and concurrent involvement of RA on laryngeal nerve and cricoarytenoid joint was revealed by laryngeal electromyography and histopathology. The vocal fold mobility was restored after 3-months medical treatment.

• Fire Science and Engineering
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• v.21 no.2 s.66
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• pp.105-110
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• 2007

This investigation contains an awareness level on the Basic Emergency Treatment of Kindergarten Teacher in emergency surgery and internal medicine situations which frequently happen at the nursery. The result says there are 59.4% of them who are fully aware of the general emergency treatment but they need to know about education the partial parts. Especially 83.2% of them misunderstood the treatment of unconscious a small child with FBAO and 82.1% of them are confused with the manual ventilation. Also 67.4% of them said they would go to the hospital without giving first aid to a burn and 53.7% have wrong emergency treatment of abrasions. The educational program for the actual situation has been proposal as the responsibility of Kindergarten teachers are raising.