• 대한기관식도과학회지
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• 제12권2호
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• pp.26-30
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• 2006

Backgroud and Objectives: Inhalation of foreign bodies in respiratory tract can be fatal to infants and child. After ventilating bronchoscopy technique was widelyused, most of the pediatric airway foreign bodies could be managed effectively. In this study, we aimed to analyze clinicalfeatures and outcomes of ventilating bronchoscopic removal of pediatric airway foreign bodies. Materials and Methods: One hundred twenty cases of ventilating bronchoscopy for pediatric airway foreign bodies at Seoul National University Hospital for the past 15 years were analyzed retrospectively. Results: In 120 cases, sex ratio (male: female) was 2.2:1 and mean age was 27.0 months. Most frequent type of airway foreign was peanut (60.2%). One hundred thirteen patients, in whom a foreign body was confirmed in the airway, were successfully managed by ventilating bronchoscopy. Delayed diagnosis and management made a significantly long postoperative hospital stay. Conclusion: Great care must be given when feeding young children, especially younger than 36 months, with nuts. Early intervention with ventilating bronchoscopy following a clinical suspicion is critical to successful treatment.

• 대한기관식도과학회지
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• 제3권1호
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• pp.84-93
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• 1997

The bronchoscopy is usually performed in the patients who present symptoms of wheezing, hemoptysis, signs of airway obstruction, unexplained long-term chronic cough with or without radiologic features of pneumonia, emphysema or atelectasis. The symptoms and signs of cases of suspected airway foreign body are of often cofused with those of asthma pneumonia and other respiratory tract disease. The ventilating bronchoscopy will be helpful for removal of certain foreign bodies as well as alleviating medically-unresponsive bronchopulmonary conditions via removing abnormal secretions or merely improving ventilation. The authors have performed clinical analysis of 59 patients who were suspected of airway foreign bodies and treated by ventilating bronchoscopy from September 1985 to February 1995. The results were as follows: 1) Among the 59 cases of bronchoscopy, 51 cases(97%) were under the age of 3. The ratio of male and female was 2.69:1 2) Most common presenting symptom was coughing(84.7%) followed by dyspnea, fever, wheezing and anterior chest pain. 3) Among 39 cases of identified foreign bodies, abnormal findings in the chest X-ray films were found in 33 cases(84.6%) and most common abnormal radiologic feature was pneumonia in 10 cases(25.6%) followed by combination of pneumonia and emphysema, or emphysema alone. All the 20 cases of absent foreign body presented abnormal radiologic features and common findings were pneumonia and atelectasis. 4) Vegetable foreign bodies were the most common form of removed airway foreign bodies(69.2%) followed by metallic foreign bodies(12.8%) and plastic foreign bodies(7.7%). 5) By distribution of the location of foreign bodies, 29 cases(74.4%) were located in the main bronchus( 16 cases of right side and 13 cases of left side), 8 cases were in the trachea and 2 cases were found at the cordal level. 6) By duration of foreign body lodgement in the airway, 9 cases(23.1%) were removed within 7 to 30 days, 10 cases(5.6%) within 3 days and 5 cases(12.8%) were enlodged over 30 days. 7) In the cases of absent foreign bodies, common bronchoscopic findings were mucopurulent or thick mucoid discharge in the main bronchi, erythema or edema of bronchial mucosa and all the cases were improved after ventilating bronchoscopy with concomitant medical management.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1977년도 제11차 학술대회연제 순서 및 초록
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• pp.8.5-9
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• 1977

기도 및 식도이물은 이비후과영역에서 적지않게 경험하게 된다. 그중 특히 유소아에서 발생하는 기도이물은 응급을 요하게 되며 진단 및 치료를 지체함으로써 예기치 않은 불행한 사태를 초래하기도 한다. 유소아에서 주로 보이는 기도이물의 증상은 기침, 기침음, 호흡곤란 등이며 천식, 폐염, 후두염 등으로 혼동되기도 한다. 이물의 종류파 빈도를 환자의 연령, 생활방식, 환경, 문과수준에 따라 그 양상을 달리한다. 저자들은 1975년부터 1977년 4월까지 본원에 내원하여 기도이물의 진단하에 ventilating bronchoscopy, thoracotomy (이중 1례는 사망)을 시행하여 치유된 35례를 분석하였다. 1. 연령층은 1세부터 5세까지가 48%로 가장많고 다음이 0세에서 1세까지 였다. 또한 남과여의 비는 2.1 : 1로 남자가 많았다. 2. 주증상은 호흡곤란, 기침, 기침음의 순서였다. 3. Foreign body의 종류는 peanut, metal, vegetable의 순이였다. 4. 이물의 소재는 주로 우측 주기관지 였으며 우측과 좌측의 비는 2 : 1이었다. 5. 내원까지의 기간은 24시간 이내가 65%로 가장 많았다. 6. 치료는 ventilating bronchoscopy가 27례로 가장 많았으며, 4례는 자연적으로 치유되었다. 이에 과거의 여러 보고들과 비교하여 문헌적 고찰과 함께 보고하는 바이다.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1978년도 제12차 학술대회연제 순서 및 초록
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• pp.4.3-5
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• 1978

식도이물은 이비인후과 영역에서 응급을 요하는 경우로서 진단 및 치료가 지체되면 예기치 않은 불행한 사태가 일어날 수 있다. 저자들은 1975년부터 1977년까지 3년간 본원에서 시도된 50례의 기도이물에 대해 고찰하였다. 1. 남여비는 2.8 : 1이였다. 2. 연령은 3개월부터 52세 사이였으며, 1세부터 5세까지가 58%로 가장 많았다. 3. 주증상은 해수: 68%, 호흡곤란: 52%, 청색증;18% 순이었다. 4. 기도이물 진단시 병력이 확실한 경우는 66%이었다. 처음 오진율은 28% 이었으며 그중 57.1%가 상기도감염으로 인한 오진이었다. 5. 처음 내원시 청진상 호흡음 감소가 46%로 가장 많았으며 그 다음 천식음이 24%, 정상이 26%이였다. 방사선 검사상 폐기종이 82%, 폐부전확장이 20%이었으며, 정상범위가 18%이었다. 6. 내원까지의 기간은 24시간이내가 48%로 가장 많았으며, 가장 오래된 것은 1년반 이었다. 내원후 제거까지의 기간은 24시간 이내가 68%이며 가장 오래 걸린 예는 9일이었다. 7. 치료는 기관절개한 경우가 24%로 그 중 75%가 식물성 기도이물이었다. Ventilating bronchoscopy로 치유된 경우는 72%이었으며. 자연배출된 경우가 8%, 기관절개창으로 자연배출된 경우가 6%, 개흉술 치유된 경우가 6%, 그외 사망, 후두직달경, 기관직달경에 의한 제거가 각각2% 이었다. 8. 기도이물의 종류는 식물성 46%, 금속성 28%, 프라스틱 18%, 동물뼈 8%이었다. 9. 이물의 소재는 기관 16% 우측기관지 52%, 좌측기관지 28%, 미상 4%이었다.

• 대한기관식도과학회지
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• 제15권1호
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• pp.28-34
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• 2009

Background and Objectives: Foreign bodies of upper aerodigestive tract are common problem for primary care physicians. Delayed diagnosis or failure of removal might cause fatal problemsand complications. Therefore proper diagnosis and management is imperative. In this study, we described clinical features of upper aerodigestive tract foreign body, and analyzed efficacy of different management modality. Materials and Methods: 250 cases of foreign bodies in the esophagus and trachea, between Jan. 1998 through Jan. 2009 has been retrospectively analyzed. A total of 24 cases and 226 cases had been found each as airway foreign bodies and esophageal foreign bodies. The clinical features are described and treatment outcomes, prognosis, and rate of complications of each management modality have been compared. Results: In airway foreign bodies, ventilating bronchoscopy yielded better results, 19 success out of 19 trials than fiberoptic bronchoscopy, 3 success out of 5 trials. Hospitalization days after removal of foreign body didn't show difference between two treatment modalities, although patients who had ventilating bronchoscopy had gone through general anesthesia. And there was no complication after removal of foreign body. In esophageal foreign bodies, rigid esophagoscope yielded better results, 99% of successful removal rate, compared to the EGD, only 78% of successful removal rate. There was no difference of hospitalization days between two modalities. And complication rate was even low in patients who had done rigid esophagoscopic foreign body removal. Conclusion: In upper aerodigestivetract foreign body. Rapid diagnosis and successful foreign body removal is important. Removal by rigid scope(ventilating bronchoscope, rigid esophagoscope) revealed less failure in both airway and esophageal foreign bodies.

• 대한기관식도과학회지
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• 제3권1호
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• pp.109-114
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• 1997

Aspiration of foreign bodies into the airway is a common problem in spite of efforts to educate the public, and it can be sometimes fatal accidents. We clinically analyzed 101 cases of airway foreign bodies treated in the Department of Otolaryngology-Head and Neck Surgery, Korea University College of Medicine for the past 10 years comparing data with the previous articles. There was male predominance in the occurrence rate, being 72% in the male patients. The peak age was 1 to 3 years of age, and 84.2% was below age of 10. The most common symptom after foreign body aspiration was intractable cough, and obstructive emphysema was most commonly found on the initial chest X-rays. Foreign bodies were mainly located at the right main bronchus and left main bronchus was the next. Peanuts were the most common airway foreign bodies. Ventilating bronchoscopy was performed in the 99 cases and foreign bodies were successfully removed in most cases. There was 2 deaths(2%) resulted from hypoxia after bronchoscopy. The fact that complication rates increase with the duration of the foreign bodies in situ is clear. Therefore, prompt bronchoscopy in patients with suspected airway foreign bodies is essential for lower complication rates.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1993년도 제27차 학술대회 초록집
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• pp.78-78
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• 1993

저자들은 1980년부터 1992년까지 세브란스병원 이비인후과에서 기관지경술을 시행하여 기도이물로 확진되었던 유소아환자 124례에 대한 분석을 시행하여 유소아 기도이물의 임상적 특성을 추시해보고자 하였으며 다음과 같은 결과를 얻었다. 1) 발병연령은 대부분(77%)이 2세 미만이었으며 최저연령은 2개월이었다. 2) 이물은 콩 종류가 가장 많은 빈도(52%)를 차지하였다. 3) 이물의 게재 위치는 자측기관지가 가장 많았으며(49%), 우측기관지(37%), 기관(14%)의 순이었다. 4)가장 빈번한 흉부방사선학적 검사소견은 폐쇄성 폐기종이었다. (60%) 5) 이물의 제거는 흡인후 일주일 이내(66%)가 가장 많았으며 1개월 이상 게재된 예(13%)도 있었다. 6) 124례 전례에서 환기형 기관지경술로 특별한 합병증없이 제거가 가능하였다. 이상의 결과로 일반적으로 알고있는 것과는 달리 좌측기관지에 더욱 호발하는 것을 알 수 있었고, 2세 미만의 유소아에게는 콩종류의 간식을 피하는 것이 좋을 것으로 생각되었다.

• 대한후두음성언어의학회지
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• 제33권1호
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• pp.37-41
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• 2022

Airway foreign body aspiration in children can lead to accidental death, due to the foreign body itself or the removal procedure. Depending on its location, removal of the foreign body can be challenging. Here, we present a case of successful removal of a foreign body from the left upper lobar bronchus via ventilating bronchoscopy with a rigid bronchoscope and Fogarty arterial embolectomy catheter. Tracheobronchial foreign bodies in locations that are difficult to reach with forceps, due to an acute angle or the small diameter of the pediatric bronchial tree, can be effectively removed with a Fogarty arterial embolectomy catheter.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1981년도 제15차 학술대회연제순서 및 초록
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• pp.4.1-4
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• 1981

저자는 1975년부터 1980년까지 서울대학교병원 이비인후과에 입원치료한 15세 이하의 기도이물환자 74례를 대상으로 임상통계학적으로 관찰하여 다음과 같은 결과를 얻었다. 1) 성별 및 연령별로 보면 유소아의 기도이물 74례중 남자 55례, 여자 18례로 남녀비는 3 : 1이며 연령분포는 2세미만이 41.8%로 가장 많고, 3세까지의 증례는 75.5%이었고, 5세까지의 증례는 83.6%이였다. 2) 증상및 이학적 소견에서는 내원시의 증상은 호흡-곤란, 기침, 청색증등이었으며, 6.7%에서는 전혀 증상이 없었다. 초진시의 이학적소견은 흡기의 감소, 천식음, 거친호흡음등이었으며 10.8%에서는 전혀 이학적 소견이 없었다. 3) 내원까지의 시간은 48.6%가 24시간내에 내원하였으나 2년이 지나서 내원한 례도 있었다. 4) 방사선학적 소견에서는 내원시의 단순흉부X-선 소견은 무기폐 25.0%, 폐기종 32.8%, 확실한 이물음영 17.2%이었고. 17.2%에서 정상이었다. 5) 이물의 종류와 개재부위는 기도이물 74례중 식물성 60.8%, 금속류가 17.5%, 프라스틱류 16.2%, 어골류, 2.7% 기타 2.7%이었다. 이물의 개재부위는 우측기관지 40.5%, 좌측기관지 31.0%, 기관 9.4%, 다발성 6.7%이었다. 6) 연령에 따른 이물의 종류를 보딘 5세이하에서는 대부분이 식물성이물이었고, 6∼15세에는 금속류와 프라스틱제품도 있었으며 특히 프라스틱 제품은 10세이상의 남자에 많았다. 7) 이물적출방법을 보면 Ventilating Bronchoscopy 82.3%, 기관절개술 2.7%, 흡입적출 2.7%, 자연배출 1.3%, 개흉술 5.4%, 사망이 5.4%이었다.

• 대한기관식도과학회지
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• 제8권2호
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• pp.36-42
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• 2002

Aspirated and ingested foreign bodies continue to present challenges to otolaryngologists. The major discussions were the accurate diagnosis and speedy, safe removal of foreign body. Many diagnostic tools have been tried and removal of foreign bodies has been facilitated by technical improvements with rod lens telescope, video endoscope, flexible fiberoendoscope and safer anesthesia. In spite of these advances, more than 3000 children's death occur per year in the world because of foreign bodies and untold number of parients survive with variable sequelae. In these study, 59 consecutive cases of children and adults with tracheobronchial foreign bodies were reviewed from 1992 to 2001. We studied the history, symptoms, ausculatory radiologic, bronchoscopic finding and post operative complications. 71% (42 cases in 59 cases) of patients had foreign body aspiration history or choking crisis. In 64% (38cases) cough was observed. 81% (48cases) had abnormal finding in chest auscultation and 78% in chest X-ray. Computed tomography was done in 12 cases, all were founded foreign body shadow. Main site of foreign body was right main bronchus (41%, 24cases) and most frequent foreign body was peanut (36% , 21cases) . 4 experienced ICU(intensive care unit) care. 2 cases were failed to remove foreign. In these cases 1 cases was improved by steroid therapy and physical therapy and the other was treated with thoracotomy. We concluded the morbidity and motality were much correlated with speedy decision making and experienced skill of operator.