Jong-Lyel Roh1, Soo-Jong Hong. 1. Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Pungnap-dong, Songpa-gu, Seoul 138-736, Republic of Korea. rohjl@amc.seoul.kr
Abstract
OBJECTIVE: Foreign body (FB) aspiration affects lung function and often results in pulmonary complications. We have assessed the clinical and radiological predictors of delayed lung recovery after rigid bronchoscopic removal of airway FBs. METHODS: The demographic data, clinical presentations, treatment profiles, pre- and post-treatment chest radiographs, and treatment outcomes were reviewed retrospectively in 104 pediatric patients who underwent removal of tracheobronchial FBs by rigid bronchoscopy. The clinical and radiological factors predicting delayed (>or=5 days) lung recovery time were statistically analyzed by logistic regression. RESULTS: Preoperative chest radiographs showed infiltrates consistent with inflammation in 21 patients (20.2%). Successful bronchoscopic removal of all FB fragments was achieved in 100 patients (96.2%). Immediate postoperative aggravation was observed in 10 patients (9.6%). Mean post-treatment pulmonary recovery was 3.8 days. On univariate and multivariate analyses, preoperative inflammation, immediate postoperative aggravation, and unsuccessful removal of airway FBs were significant predictors for delayed lung recovery. The preoperative inflammatory and immediate postoperative chest radiologic findings were significantly correlated (p<0.001). CONCLUSIONS: Delayed lung recovery after rigid bronchoscopic removal of tracheobronchial FBs can be predicted by FB-induced inflammatory chest radiologic findings and the unsuccessful or complicated removal of airway FBs.
OBJECTIVE: Foreign body (FB) aspiration affects lung function and often results in pulmonary complications. We have assessed the clinical and radiological predictors of delayed lung recovery after rigid bronchoscopic removal of airway FBs. METHODS: The demographic data, clinical presentations, treatment profiles, pre- and post-treatment chest radiographs, and treatment outcomes were reviewed retrospectively in 104 pediatric patients who underwent removal of tracheobronchial FBs by rigid bronchoscopy. The clinical and radiological factors predicting delayed (>or=5 days) lung recovery time were statistically analyzed by logistic regression. RESULTS: Preoperative chest radiographs showed infiltrates consistent with inflammation in 21 patients (20.2%). Successful bronchoscopic removal of all FB fragments was achieved in 100 patients (96.2%). Immediate postoperative aggravation was observed in 10 patients (9.6%). Mean post-treatment pulmonary recovery was 3.8 days. On univariate and multivariate analyses, preoperative inflammation, immediate postoperative aggravation, and unsuccessful removal of airway FBs were significant predictors for delayed lung recovery. The preoperative inflammatory and immediate postoperative chest radiologic findings were significantly correlated (p<0.001). CONCLUSIONS: Delayed lung recovery after rigid bronchoscopic removal of tracheobronchial FBs can be predicted by FB-induced inflammatory chest radiologic findings and the unsuccessful or complicated removal of airway FBs.