Charlotte K Hughes1, Christine L Christensen2, Stephen C Maturo3, Peter R O'Connor4, Gregory R Dion1,5. 1. Department of Otolaryngology-Head and Neck Surgery, Brooke Army Medical Center, San Antonio, Texas, U.S.A. 2. Clinical Investigation and Research Support, 59th Medical Wing, United States Air Force, San Antonio, Texas, U.S.A. 3. Department of Otolaryngology-Head and Neck Surgery, Walter Reed National Military Medical Center, Bethesda, Maryland, U.S.A. 4. Department of Otolaryngology-Head and Neck Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany. 5. Dental and Craniofacial Trauma Research Department, U.S. Army Institute of Surgical Research, San Antonio, Texas, U.S.A.
Abstract
OBJECTIVE: We sought to determine the time course of clinical and histologic differences between aspirated inorganic and organic foreign bodies. STUDY DESIGN: In-vivo. METHODS: Twenty Sinclair miniature swine (Sus scrofa domesticus) were divided into two groups-inorganic or organic foreign bodies. Either an organic (peanut) or an inorganic (Lego) foreign body was placed within a bronchus and left for 3, 5, 7, 14 or 21 days. The airway was reassessed at the predetermined endpoint at which time endoscopic, gross, and histopathological findings were documented. Specimens were scored with a pathologic scoring system to assess injury severity from the foreign body. RESULTS: Foreign bodies were successfully placed in all 20 swine. Two animals required early euthanasia due to respiratory compromise. The foreign body was identified grossly in eight (40%) animals. An additional three (15%) had microscopic evidence suggestive of a previous foreign body of an undetermined duration. There was no difference in injury severity between organic and inorganic foreign bodies. The 3-day group had injuries limited to the bronchial lining, whereas the longer duration groups had bronchial and adjacent lung parenchymal involvement. There was no difference in injury severity between days 5 and 21. CONCLUSIONS: Airway foreign bodies initially cause bronchial damage. After 5 days, the foreign body causes lung parenchymal changes. There was no difference in airway lesion severity between organic and inorganic foreign bodies. LEVEL OF EVIDENCE: N/A Laryngoscope, 131:490-495, 2021. Published 2020. This article is a U.S. Government work and is in the public domain in the USA.
OBJECTIVE: We sought to determine the time course of clinical and histologic differences between aspirated inorganic and organic foreign bodies. STUDY DESIGN: In-vivo. METHODS: Twenty Sinclair miniature swine (Sus scrofa domesticus) were divided into two groups-inorganic or organic foreign bodies. Either an organic (peanut) or an inorganic (Lego) foreign body was placed within a bronchus and left for 3, 5, 7, 14 or 21 days. The airway was reassessed at the predetermined endpoint at which time endoscopic, gross, and histopathological findings were documented. Specimens were scored with a pathologic scoring system to assess injury severity from the foreign body. RESULTS: Foreign bodies were successfully placed in all 20 swine. Two animals required early euthanasia due to respiratory compromise. The foreign body was identified grossly in eight (40%) animals. An additional three (15%) had microscopic evidence suggestive of a previous foreign body of an undetermined duration. There was no difference in injury severity between organic and inorganic foreign bodies. The 3-day group had injuries limited to the bronchial lining, whereas the longer duration groups had bronchial and adjacent lung parenchymal involvement. There was no difference in injury severity between days 5 and 21. CONCLUSIONS: Airway foreign bodies initially cause bronchial damage. After 5 days, the foreign body causes lung parenchymal changes. There was no difference in airway lesion severity between organic and inorganic foreign bodies. LEVEL OF EVIDENCE: N/A Laryngoscope, 131:490-495, 2021. Published 2020. This article is a U.S. Government work and is in the public domain in the USA.
Entities:
Keywords:
Airway foreign body; airway; aspiration; bronchoscopy; tracheobronchial foreign body
Authors: Diego Iacono; Erin K Murphy; Paul M Sherman; Holly Chapapas; Bianca Cerqueira; Christine Christensen; Daniel P Perl; John Sladky Journal: Sci Rep Date: 2022-04-27 Impact factor: 4.996