• Korean Journal of Bronchoesophagology
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• v.12 no.2
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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.

• Korean Journal of Bronchoesophagology
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• v.3 no.1
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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.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1977.06a
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• pp.8.5-9
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• 1977

Foreign bodies in food and air passage, especially the latter in infants and children requires emergency treatment. The frequent symptoms are coughing, wheezing, and dyspnea, So may be confused as asthma, pneumonia and acute Laryngitis. The species and incidence of the foregin bodies are variable according to the age, method of life, environment and economic condition. The authors experienced 35 cases of foreign body in air passage during the period of last 3yrs which were treated by ventilating Bronchoscopy, and thoractomy in this hospital. One of them was lead to death. The authors analysed above cases and report with it's literature consideration. Results: 1. The prevalent foreign bodies were peanut, metal, food particles in order of frequency. 2. In frequent symptoms were dyspnea, coughing and wheezing in the order. 3. In the age incidence, 48% of the foreign bodies were 1∼5yrs. 4. In sex distribution, male to female ratio was 2.1: 1 5. In duration of lodgment, 65% of the foreign body were removed within 24hrs. 6. Most prevalent site of the foreign body was Rt. main bronchus Rt. to Lt. ratis was 2 : 1 was 7. Treatment was done; 25 cases were by ventilating bronchoscopy.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1978.06a
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• pp.4.3-5
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• 1978

The foreign bodies in air way require the emergent managements in the otolaryngolagic field, and if the diagnosis and treatment were delayed, unexperted catastrophic situations may occur. The authors had analysed the airway foreign bodies of 50 cases which had been ventilating bronchoscopy. 1. In sex distribution, male to female ratio was 2.8 : 1. 2. In the age incidence, 58% were 1∼5 yrs. 3. Frequent symptoms, were coughing (68%), dyspnea (52%) and cyanosis (18%) in the oder. 4. The significant foreign body histories were noticed in 33 cases (66%). The initial misdignosis were 28%, and af which 57.1% were URI 5. In auscultation, decreased breathing sounds were noticed in 46%, wheezing were 24% and 26% were with in normal limit. 6, In duration af lodgement, 68% were removed within 24 hours. 7. Tracheostomy were performed in 24%, and foreign bodies were removed by ventilating bronchoscope in 72%. 8. The foreign bodies were vegetable (46%), metal (28%), plastic (18%) and fish bone (8%). 9. The prevalent site of foreign body were right main bronchus, left main bronchus, and trachea in the order mentioned.

• Korean Journal of Bronchoesophagology
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• v.15 no.1
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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.

• Korean Journal of Bronchoesophagology
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• v.3 no.1
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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.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1993.05a
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• pp.78-78
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• 1993

The authors performed clinical analysis on 124 cases of airway foreign bodies in children treated by ventilating bronchoscopy at Severance hospital from 1980 to 1992. The results were as follows ; 1) The most of the cases were below age of 2.(71%) 2) Nuts were the most common airway foreign body.(52%) 3) The grequent loci of airway foreign body were left main bronchus(49 cases), right main bronchus(38 cases), trachea(17 cases) in order. 4) The most common chest X-ray findings were obstructive emphysema.(60%) 5) By duration of lodgement in the airway, 82 cases(66%) were removed within 1 week and 16 cases(13%) over 30 days. 6) All of 124 cases were successfully treated by ventilating bronchoscopy without serious complications. In conclusion, the left bronchus was the most common location of foreign bodies and it would be advisable to avoid nuts for snack below the age of 2.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.33 no.1
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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.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1981.05a
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• pp.4.1-4
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• 1981

The statistical study was done on 74 cases of foreign bodies in the air passages, who visited the department of otolaryngology of SNUH during recent 5 years from 1975 to 1980. The result was as follows, 1) Of the total 74 cases, 55 cases were male and 18 cases were female. The ratio between male and female was 3 : 1. 41.8% of all-cases were under 2 years of age, 75.5% were under 3 years, and 83.6% were under 5 years. 2) Major symptoms on visit were dyspnea, cough, cyanosis. No significant symptoms was noted in 6.7%. Initial physical findings were coarse breathing sound, decreased breathing sound, and stridor. No abnormal physical findings were noted in 10.8%. 3) 48.6% of total cases visited hospital within 24 hours. There was one case who visited hospital over 2 years later. 4) Initial simple chest film showed atelectasis in 25.0%, emphysema in 32.8%, definite foreign body shadow in 17.2% and within normal limit in 17.2%. 5) 60.8% of total cases were vegetables, 15.5% were metals, 16.2% were fish bone, and 2.7 % were others. 6) Vegetables were most frequent foreign bodies in the cases under 5 years of age. 7) 40.5% of total cases were lodged in the right main bronchus, 31.0% were in the left main bronchus, 9.8% were in trachea and 6.7% were in multiple sites, 8) Foreign bodies were removed by ventilating bronchoscopy in 82.3%, by tracheostomy only in 2.7%, by tracheal suction in 2.7%, by spontaneous removal in 1.3%, by thorachotomy in 5.4% and 5.4% of total cases were expired.

• Korean Journal of Bronchoesophagology
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• v.8 no.2
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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.