Clinico-radiological predictors of positive rigid bronchoscopy findings in children with suspected tracheobronchial foreign body aspiration

Abstract

Background: Tracheobronchial foreign body aspiration (TFBA) is common in young children and is associated with potentially significant morbidity, and sometimes mortality. Although rigid bronchoscopy (RB) is often needed for definitive diagnosis, it can be associated with intra-operative and long-term risks. Methods: Hospital records of patients under 18 years of age who underwent RB for suspected TFBA between November 2010 and May 2016 were retrospectively reviewed. Data extracted include age, gender and date of TFBA. Specific pre-operative clinical and radiological findings were compared with findings at RB. Results: Of 43 children admitted with suspected TFBA, 72% were aged under 3 years. 79.1% had a FB identified at RB. Clinical history of inhalation, auscultation and radiographic abnormalities [hyperinflation, collapse, suspected foreign body (FB)] were not significantly different for children with, compared to those without, TFBA at RB. Conclusions: Although RB remains the definitive management for suspected TFBA, the potential risks and non-specific clinical and radiological findings mean other imaging techniques such as low dose multidetector computed tomography (MDCT) should be explored.