Management of Laryngo-Tracheo-Bronchial foreign bodies in children at the Adolphe SICE General Hospital in Pointe-Noire, Congo

Abstract

Background: The objectives of our study were to describe the epidemiological, diagnostic, therapeutic and evolutionary aspects of laryngotracheobronchial foreign bodies. Patients and methods: This was a descriptive and retrospective study carried out over a period of 12 years (2007-2019), in the ENT and cervico-facial surgery department of the General Hospital Adolphe SICE of Pointe-Noire (Congo). Results: During this period, we collected 20 files of patients whose age varied from 1 to 10 years with an average age of 5 years who were received for foreign body inhalation. The average age of our patients was 5 years with extremes ranging from 1 to 10 years. A male predominance was noted with a sex ratio of 1.62. The average consultation time was 3 days (2 hours and 30 days), 12 patients (60%) were seen within the first 24 hours. The penetration syndrome was the most common functional sign in 10 cases (50%). The standard cervico-thoracic radiograph was normal in 7 cases (35%). The foreign body was opaque in 10 cases (50%), and in 1 case atelectasis was noted. CT scan was performed in 2 cases (10%). The larynx was the most common location. Indeed, the glottis was affected in 8 cases (61.5%), followed by the supraglottis in 3 cases (23.07%) and the subglottis in 2 cases (15.3%). The plastic toys were found more in the glottis in 6 cases (30%). The evolution after endoscopy was favourable in 17 cases (85%), 2 cases required thoracic surgery, and one death was recorded. Conclusion: Laryngo-tracheo-bronchial foreign bodies are frequent, they pose a public health problem. Their management depends on the strength of the relationship between the ENT surgeon and the anaesthetist. Keywords: Child; Laryngo-Tracheo-Bronchial Foreign Bodies; Endoscopy