Is Early Diagnosis of Foreign Body Aspiration Effective in Reducing Re-bronchoscopy in Children?

Abstract Background:Flexible Fiber-optic Bronchoscopy (FFB) is a diagnostic and therapeutic tool for respiratory diseases and evaluation. One of its major advantages is in the diagnosis and treatment of foreign body aspiration.Objectives:This study reports the indications, outcomes, and possible complications of FFB in patients suspected of foreign body aspiration diagnosis in the Iranian population.Methods:The data for this study was gathered from medical records of the patients in Children’s Medical Centre, which is a tertiary pediatric hospital affiliated with Tehran University of Medical Sciences (TUMS), from August 2015 to February 2021.Results:Of the 358 FFBs that were performed for patients suspected of foreign body aspiration diagnosis, major indications included choking (158, 44.13%), coughing (157, 43.58%), wheezing (34, 9.49%), and stridor (6, 1.67%). Nuts were the most common foreign body that was removed among airways in these patients (116, 65.16%). In 15 (4.18%) cases the foreign object was extracted via re-bronchoscopy. The location of 130 foreign objects was identified which right bronchus (52, 40%), left bronchus (38, 29.23%), trachea (8, 6.15%), and carina (6, 4.61%). In 358 procedures that were performed, a total of 27 cases (7.54%) developed complications include hypoxia and laryngospasm. The mean interval from the first sign of choking and the admission of the child into the hospital was 44.43 days ± 10.88 (range: 1 to 1095 days, 95% CI: 22.87-65.99). There was a significant association between later days of admission and the necessity for re-bronchoscopy according to the logistic regression test (p-value=0.012).Conclusion:Our results show that by early diagnosis and hospitalization and so performing flexible fiber-optic bronchoscopy in an earlier time than foreign body aspiration can increase the number of successful procedures.