Laryngotracheobronchial foreign body in children: predictive factors of respiratory sequelae

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Published May 5, 2010
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Vol. 88 No. 5 (2010): Issue May 2010

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Tinsa F
Yahyaoui S
Jallouli M
Bousnina D
Slim I
Zouari B
Boussetta K
Bousnina S

Abstract

Background : Inhalation of laryngotracheobronchial foreign body in children is a serious accident that may compromise the prognosis of the child and the respiratory function in the long term.
Aim: identify the predictive factors of respiratory sequelae of laryngotracheobronchial foreign body inhalation.
Methods: This retrospective study was conducted in the children hospital of Tunis during a period of nine years (2000 - 2008). In all statistical tests, the significance level was set at 0.05.
Results : 60 children were included in the study. The average age was 24.9 ± 3.4 months. 2 / 3 of the children were boys. The foreign body was plant in 80% of cases. The penetration syndrome was reported in 83.7% of cases. The average time of stay of foreign body was 14 days. The chest radiograph was abnormal in 77.4% of cases. Endoscopic extraction was performed in 59 cases and a pneumectomy was conducted in one child. 30 children were followed for an average of 23 months. 18 children had not respiratory sequelae (clinical, radiological and scintigraphic). 10 children had respiratory sequelae (clinical and radiological and/or scintigraphic) at the last follow-up and four patients developed bronchial dilatation. Respiratory sequelae were correlated with the stay period of the foreign body exceeding 84H. Neither age, nor sex, nor the nature of foreign body or its location, nor the presence of radiological opacity at the initial radiograph, were predictive factors of respiratory sequelae.
Conclusion: The inhalation of foreign body is a serious accident affecting essentially male infants.Clinical, radiological and scintigraphic follow up is mandatory.

Keywords:

Laryngotracheobronchial foreign body, children, respiratory sequelae, ,

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References

  1. Khiati M, Couvreur J, Grimfeld A, et al. Les aspects pneumologiques du corps étranger bronchique chez l'enfant. Expérience de 100 cas. Rev Pneumol Clin 1984 ; 40 : 221-6
  2. Piepsz A. Late sequealae of foreign body inhalation. A multicentric scintigraphic study. Eur J Nucl Med 1988; 13: 578-81
  3. Dutau G, Sablayrolles B, Petrus H, et al. Séquelles respiratoires à court et à moyen terme des CE bronchiques. Rev Fr Mal Resp 1981 ; 9 :358
  4. Svensson G. Foreign bodies in the tracheobronchial tree. Special reference to experience in 97 children. Int J Pediatr Otorhinolaryngology 1985;8:243-251
  5. Ployet MJ, Robier A, Goga D, et al. CE laryngo-tracheo-bronchiques. Encycl. Med. Chir,Oto-rhino-laryngologie 7-1987, 20730 A 10 : 10p
  6. Davies H, Gordon L, Matthew DJ, et al. Long term follow up after inhalation of foreign bodies. Arch Dis Child 1990; 65:619-21
  7. Kero P, Puhakka H, Erkinjuntti M, et al. Foreigh body in the airways of children. Int J Pediatr Otorhinolaryngol 1983; 6:51-59
  8. Liancai MU, Ping HE, Deqiang SUN. Inhalation of foreign bodies in Chinese children. Areview of 400 cases. Larygoscope 1991; 101: 657-660
  9. Wolach B, Raz A, Wein Sey J, et al. Aspirated foreign bodies in the respiratory tract of children: eleven years experience with 127 patients. Int J Pediatr Otorhinolaryngol 1994; 30: 1-10
  10. Francois M, Thach T, Maisani D, et al. Endoscopie pour recherche de corps étrangers des voies aériennes inférieures chez l'enfant. A propos de 668 cas. Ann Otolaryng 1985 ; 102 : 433-441
  11. Donato L, Weiss L, Bing J, et al. Corps étrangers trachéo-bronchiques. Arch pediatr 2000; 7 suppl1: 56-61
  12. Aytac A, Yurdakul Y, Ikizler C, et al. Inhalation of foreign bodies in children. Report of 500 cases. J Thorac Cardiovasc Surg 1977; 74: 145-151
  13. Oguzkaya F, Akcali y, Kahraman C, et al. Tracheobronchial foreign body aspirations in childhood : a 10 year experience. Eur J cardiothorac Surg 1998; 14: 388-392
  14. Campbell DN, Cotton EK, Lilly R. A dural approach to tracheobronchial foreign bodies in children. Surgery 1982; 91: 178-82
  15. Rothmann BF, Boechkma CR. Foreign bodies in the larynx and tracheobronchial tree in children a review of 225 cases. Ann Oto Rhino Laryngol 1980; 89:434-6
  16. Banerjee A, Rao KS, Khana SK, et al. J Laryngol Otol 1998; 102: 1029-32
  17. Baharloo F, Veyckemans F, Francis C, et al. Tracheobronchial foreign bodies. Chest 1999; 115: 1357-62
  18. Burton EM, Brick WG, Hall JD, et al. Tracheobronchial foreign body aspiration in children. South Med J 1996; 89: 195-8
  19. Hoeve LJ, Rombout J, Pot DJ. Foreign body aspiration in children. the diagnostic value of signs symptoms and preoperative examination. Clin Otorhinol 1993; 18: 55-57
  20. Al Majed SA, Achour M, El Moubarek AF, et al. Overlooked inhaled foreign bodies: late sequelae and the likelihood of recovery. Res Med 1997; 91: 293-6
  21. Daoud AS. Child bronchoscopy in Iraq. J ORL 1965; 79: 902
  22. Sabeti H, Hacherian DJ. Pronostic actuel des corps étrangers des voies aériennes et digestives. Ann Otolaryngol 1975 ; 92 : 31
  23. Labbe A. Qu'est ce qui différencie l'enfant de l'adulte du point de vue respiratoire ? Pneumologie de l'enfant. Dutau G, Labbe A, eds. Arnette Blackwell SA, Paris 1996 : 3-5
  24. Law D, Kosloske AM. Management of tracheobronchial foreign bodies in children. A reevaluation of postural drainage and bronchoscopy. Pediatrics 1979; 58: 362