Tracheobronchial Foreign Bodies In Children Research Articles

Clinical analysis of special types of tracheobronchial foreign bodies in children.

To explore the clinical diagnosis and treatment of special types of tracheobronchial foreign bodies in children and provide a reference for clinicians to formulate treatment plans. Clinical data of 29 children with special types of tracheobronchial foreign bodies who were treated at The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University between June 2017 and June 2022 were collected and analyzed, and their diagnosis and treatment processes were reviewed. All 29 special types of foreign bodies were successfully removed using rigid bronchoscopy under general anesthesia, with no surgical complications. For the treatment of special types of tracheobronchial foreign bodies, clinicians should make detailed surgical plans and select appropriate instruments according to different conditions to improve the surgical success rate and reduce the occurrence of complications.

Tracheobronchial Foreign Body in Children with an Insidious Medical History.

This study explored the clinical features of tracheobronchial foreign bodies (TFB) in children lacking both a foreign body aspiration history and bronchial cut-off signs on imaging. This study was conducted between 2011 and 2021, including 45 children without a choking history or tracheal interruption on CT scans. Common symptoms were cough and wheezing (91.1%, 41 cases), followed by decreased breath sounds (55.6%, 25 cases), rales (48.9%, 22 cases), and wheezing (42.2%, 19 cases). Prior to TFB confirmation, bronchopneumonia was the prevalent diagnosis (88.9%, 40 cases). Vegetable matter was the most frequent foreign body type (75.6%, 34 cases), primarily located in the right main bronchus (31.1%) and left lower lobe bronchus (22.2%). TFB in children with obscure medical histories presents non-specifically, highlighting bronchoscopy's pivotal role in diagnosis and treatment. Key Words: Bronchoscope, Paediatrics, Tracheobronchial foreign body, Diagnosis.

Risk factors for difficult removal of tracheobronchial foreign bodies in children by rigid bronchoscopy.

To characterize the risk factors for difficult removal of tracheobronchial foreign body (FB) by rigid bronchoscopy in children. We retrospectively analyzed clinical data of 1026 pediatric patients (age: 0-18 years) diagnosed with tracheobronchial FB between September 2018 and August 2021. All patients underwent rigid bronchoscopy as the first intervention at our hospital. Children aged 1-3 years accounted for 83.7% cases in our cohort. The most common symptoms were cough and wheeze. FBs were more frequently found in the right bronchus, and trachea FBs accounted for only 8.19% cases. The success rate of rigid bronchoscopy in a single attempt was 97.27%. 12.18% of the cases were defined as difficult removal of FB. On univariate analysis, age, CT findings (pneumonia), type of FB, diameter of FB, FB location, granulation tissue formation, and the seniority of the surgeon were identified as risk factors for difficult removal of tracheobronchial FBs. On multivariate analysis, age ≥3 years, FB diameter ≥10mm, FBs located in left bronchus, multiple FBs, granulation tissue, and the seniority of surgeon (<3 years, ≥5 years) were independent risk factors for difficult removal. Age, FB diameter, location of FB, granulation tissue formation, and the seniority of the surgeon were risk factors for difficult removal of FBs by rigid bronchoscopy.

Characteristics and Treatment of Pediatric Tracheobronchial Foreign Bodies: A Retrospective Analysis of 715 Cases.

BACKGROUND This study aimed to analyze the clinical characteristics of tracheobronchial foreign bodies in children in Shenzhen and to explore the diagnosis and treatment methods for special cases. MATERIAL AND METHODS This study included a total of 715 children who were diagnosed with tracheobronchial foreign bodies at Shenzhen Children's Hospital between October 2016 and October 2021. Data on sex, age, inducement, symptoms, foreign body type, foreign body location, foreign body retention time, foreign body history, and complications were recorded and analyzed. RESULTS Tracheal foreign bodies were found to occur primarily in children aged 0-2 years (90.6%). The overall incidence rates were 69.1% and 30.9% in boys and girls, respectively. Among them, 42.5% of the foreign bodies were detected in the left bronchus and 45.6% in the right bronchus. Inducements included playing while eating (n=398, 55.7%) and also crying (n=209, 29.2%). Operations were performed on 710 (99.3%) children, including 80 (11.2%) immediate surgeries and 2 tracheotomies. One child had no vital signs upon admission and died after emergency foreign body removal. All of the other children who underwent surgery recovered well postoperatively. CONCLUSIONS This study presents the characteristics and methods of diagnosis and treatment of tracheobronchial foreign bodies in pediatric patients in Shenzhen. Tracheobronchial foreign bodies are a major cause of accidental injury in infants and young children. In critical cases, airways should be immediately and rapidly cleared with multidisciplinary collaboration. In addition, public safety awareness should be strengthened, particularly among parents, teachers, and other child caregivers, to reduce and prevent instances of tracheobronchial foreign body accidents in children.

Tracheobronchial Foreign Bodies in Children: Experience From 1,328 Patients in China.

Objective:To analyze the clinical characteristics of tracheobronchial foreign body (FB) cases in a pediatric Chinese population.MethodsThe clinical data of pediatric patients aged 0–18 years old diagnosed with a tracheobronchial FB in the Children's Hospital of Chongqing Medical University between September 2018 and August 2021 were analyzed retrospectively.ResultsAmong 1,328 included cases, 92.09% of patients were <3 years old, the male to female ratio was 1.86:1. The prevalence of tracheobronchial FB was similar between patients living in rural and urban areas and tracheobronchial FBs were more common in winter. The most common presenting symptoms were cough and wheezing. The most common CT findings was local obstruction or tracheobronchial narrowing, followed by obstructive emphysema of lung and pneumonia. The 11.3% of cases that did not report FB aspiration on admission had a longer time to hospital admission and longer hospitalization time than cases reporting FB aspiration (P < 0.05). The most common FB type was nuts (81.17%). FBs were more frequently located in the right bronchus, and 64 (4.82%) cases involved multiple FBs. FBs were expelled by coughing in only 4.07% of cases. For the other cases, FB removal by first bronchoscopy in our hospital was successful and complete in 96.86% of cases. 1.51% of patients had hypoxic ischemic encephalopathy (HIE) and the location of FBs was a possible risk factor for HIE (P < 0.05).ConclusionsTracheobronchial FBs occurred most commonly in children <3 years old. If asphyxia occurs in children which FBs aspirated, emergency treatment is needed to reduce the occurrence of HIE. Rigid bronchoscopy remains the first-line method for FB removal in children.

Management of Tracheo-Bronchial Foreign Bodies in Children: Our Experience.

(1) To study the epidemiological profile of the patients. (2) To study the various modalities of investigations to arrive at confirmatory diagnosis. (3) To study the post-operative complications. It was a hospital based prospective study. A total of 36 paediatric patients were included in the study over a duration of 2years (August 2017 to July 2019). Written informed consent was taken from the parent of each patient before performing bronchoscopy. All the patients were subjected to careful clinical examination and investigations required followed by emergency bronchoscopic removal of foreign body. The patients were followed up at 1 and 3months after bronchoscopic removal. Amongst the 36 cases, 12 cases presented with airway emergency which addressed by bronchoscopic removal immediately. 10 cases presented with suggestive history of foreign body aspiration were subjected to clinical and radiological studies followed by bronchoscopic removal. 14 cases were referred from paediatric in-patient department who were being treated for unresolved LRTI. Early intervention is life saving if timely done. Unresolved LRTIs should be looked carefully to address missed foreign bodies. HRCT Thorax with 3-D reconstruction (Virtual Bronchoscopy) helps in exact localization of the foreign body. Experienced team of surgeons and anesthetist along with a ICU support is needed for efficient management.

Comprehensive Analysis of the Diagnosis and Treatment of Tracheobronchial Foreign Bodies in Children.

To analyze the factors influencing the diagnosis and treatment of tracheobronchial foreign bodies (TFBs) in children. The clinical data of 300 consecutive children with suspected TFBs who were admitted to our department between January 2016 and December 2019 were retrospectively collected, including demographics, diagnosis, history of foreign body inhalation, preoperative chest computed tomography (CT) findings, duration of foreign body retention, time from admission to operation, operation duration, duration of hospitalization, and complications. Among the 300 cases, the male:female ratio was 193:107, and the age range was 6 months to 12 years (median age: 19 months). A total of 291 cases (97.0%) involved TFBs confirmed by rigid bronchoscopy, while the other 9 cases (3.0%) involved bronchopneumonia. The diagnostic accuracy, sensitivity, and specificity of a history of foreign body inhalation and chest CT were 96.0%, 98.6%, and 11.1% and 97.7%, 97.6%, and 100%, respectively. The duration of hospitalization, time from admission to operation, and operation duration were all related to bronchopneumonia (P < .05). A detailed history, adequate physical examination, and preoperative imaging examination help improve the diagnostic accuracy. Preoperative bronchopneumonia in children with TFBs will increase the surgical risks and treatment costs, prolonging the duration of hospitalization.

Anesthetic effect and safety of sevoflurane combined with propofol in removing tracheobronchial foreign bodies in children.

To systematically evaluate the anesthetic effect and safety of sevoflurane combined with propofol in removing tracheal foreign bodies in children. PubMed, EMbase, The Cochrane Library, China Biomedicine Database, China National Knowledge Internet, WanFang Data, and VIP databases were searched. Randomized controlled trials (RCTs) of sevoflurane combined with propofol for anesthesia during tracheal foreign body extraction in children were collected. The retrieval time was from the establishment of the database to April 10, 2019. RevMan 5.3 software was used for meta-analysis after two researchers independently screened the literature, extracted data, and evaluated the risk bias included in the study. Seven RCTs involving 473 patients were included. Meta-analysis showed that the time of loss of consciousness significantly reduced (MD=-38.27, 95% CI (-41.77, -34.77), p < 0.00001) and the recovery time significantly reduced (MD=-12.29, 95% CI (-2.77, -1.80), p < 0.00001) in the sevoflurane combined with propofol group compared with the control group. In terms of safety, the heart rate was slower [MD=-11.00, 95% CI (-21.64, -0.36), p=0.04 < 0.05] and the incidence of cough and breath holding was lower [MD=0.38, 95% CI (0.19, 0.78), p=0.008] in the sevoflurane combined with propofol group than in the control group. However, no significant difference in respiratory rate and SPO 2 < 90% was found between the two groups (p > 0.05). Sevoflurane combined with propofol is worth popularizing because of its high anesthetic effect and safety in the removal of tracheal foreign bodies in children. However, given the limited quantity and quality of the included studies, the above conclusions need to be verified by high-quality studies.

The role of flexible bronchoscopy accomplished through a laryngeal mask airway in the treatment of tracheobronchial foreign bodies in children

IntroductionWe here present our experience with children who underwent flexible bronchoscopy for removal of inhaled tracheobronchial foreign bodies under general anesthesia via a laryngeal mask airway (LMA). Materials and methodsA total of 24 (16 male and 8 female, mean age: 30.75 ± 29.68 months) patients who underwent flexible bronchoscopy under general anesthesia using a LMA for suspicion of tracheobronchial foreign bodies between July 2016 and April 2018 were retrospectively reviewed. ResultsThe mean duration of admission to hospital was 162.56 ± 309.56 h. Sixteen (66.7%) patients were found to have tracheobronchial foreign bodies. All procedures were successfully accomplished through a LMA by using basket forceps, a Fogarty catheter and a suction without any need for rigid bronchoscopy. 11 (68.7%) of tracheobronchial foreign body locations were right bronchial, 3 (18.8%) were left bronchial and 2 (12.5%) were tracheal. The types of extracted tracheobronchial foreign bodies were organic in 14 (87.5%) and non-organic in 2 (12.5%). There were no complications except laryngeal edema noted in 2 (8.3%) patients, relieved within 48 h. The mean time of postoperative hospitalisation was 2.42 ± 0.97 days. ConclusionFlexible bronchoscopy accomplished through a LMA is a safe, easy and effective technique, not only as a diagnostic procedure, but also as the initial therapeutic modality for retrieving tracheobronchial foreign bodies in children with high success and low complication rates. With further reports aforementioned, we hope that the flexible bronchoscopy will become a standard method in children.

Experts consensus on diagnosis and treatment of tracheobronchial foreign bodies in children

Experts consensus on diagnosis and treatment of tracheobronchial foreign bodies in children

A simple management option for chronically impacted sharp tracheobronchial foreign bodies in children

Distally impacted chronic tracheobronchial sharp foreign bodies in children are a management challenge that presents with clinical subtlety and extreme variability. The use of image guided techniques, imaginative instrumentation, tracheotomy, thoracotomy, and even extracorporeal membrane oxygneation have been reported. Endoscopy is made difficult by the distal location, inflammatory reaction with granulation tissue formation, and bleeding obscuring the foreign body. Our aim is to describe our experience with two children who had removal of aspirated impacted sharp metallic foreign bodies from the distal airway using rigid bronchoscopy, preceded by maximal medical therapy.

Tracheobronchial Foreign Bodies in Children: The Role of Emergency Rigid Bronchoscopy.

Foreign body aspiration (FBA) is a common and lethal accident in the pediatric age group. It requires early recognition and treatment by rigid bronchoscopy to avoid fatal outcomes. Objective. The aim of this study was to study the pattern of FBA in the tracheobronchial tree as well as the success rate of rigid bronchoscopy in children admitted to a single center and to analyze the relationship of the type of foreign body (FB) with patients’ age, presentation, and complications. Methods. A retrospective cross-sectional study of FBA was conducted in children in the Sulaimani/Kurdistan region, Iraq, admitted to the emergency teaching hospital of the University of Sulaimani from January 2014 to March 2016. Result. Data of 83 patients between 6 months and 15 years old were studied. The most affected was the 1- to 5-year-old group. There was a slight female predominance (male to female ratio 0.93:1). The most common FB was sunflower seed (49.4%). History of choking was present in 92.8% of patients; 55.4% had normal air entry, and 37.3% had no added sound on chest auscultation. Normal chest X-ray (CXR) was found in 40% of patients. The most common site was the right bronchial tree (39.8%). Two patients needed mechanical ventilation; both of them died. There was a significant relationship between the type of FB (P = .013, .000, respectively). Conclusion. Medical history is the most important factor for reaching the diagnosis; bronchoscopy is mandatory if choking was witnessed, even if examination and CXR are normal. Organic material causes more local reaction than nonorganic material.

Risk factors for granuloma formation in children induced by tracheobronchial foreign bodies

ObjectiveThe aim of this study was to analyze the risk factors for granuloma formation caused by plant-based tracheobronchial foreign bodies in children, and investigate the underlying pathogenesis. MethodIn this retrospective analysis of 153 cases with tracheobronchial foreign bodies (peanuts and watermelon seeds), 35 cases of granuloma formation as granulation group (G), and 118 cases of no granuloma formation as non-granulation group (NG) were studied. Clinical data pertaining to sex (S), age (A), foreign body surface smoothness (SF), foreign body shape (SH), foreign body oil release state (O), the location of foreign bodies (L), and foreign body retention time (T) were collected for statistical analysis. ResultsUnivariate analysis showed no significant difference between the two groups (G and NG) with respect to S, A, SH and L. Significant factors based on univariate analysis included SF, O and T. Multivariate logistic regression analysis revealed that SF and T were independent risk factors associated with development of granuloma. ConclusionsSF, O and T had relationship with the granuloma formation. Local trauma caused by an irregular and sharp foreign body, and extended period of time represent the main factors causing granuloma formation.

Management and prevention of foreign body aspiration in children

Objective To put forward the prevention advice on foreign body suction, and to discuss the efficacy, safety and application experience of flexible bronchoscopy in the diagnosis and treatment of tracheobronchial foreign bodies in children. Methods The treatment experience of 38 cases for airway foreign body removal with flexible bronchoscopy and granulation tissue proliferation in Argon plasma coagulation(APC)(argon knife) combining carbon dioxide(CO2) cryotherapy in Bayi Children's Hospital Affiliated to General Hospital of Beijing Military Command from January 2013 to December 2014 were reviewed, and the clinical data including age, gender, treatment time for inhaled foreign body, clinical and X-ray manifestations, location of the foreign body, treatment with bronchoscopy with APC and cryotherapy, complications and outcomes were analyzed. Results There were 38 cases of patients including 31 male(81.6%) and 7 female(18.4%), aged from 10 months to 14 years old, with mean age 28.5 months; among them there were 30 cases with definite history of foreign body, accounting for 78.9%; the most common clinical symptom was cough among the cases, accounting for 84.3%; X ray showed 15 cases with ipsilateral lung atelectasis, accounting for 39.5%, emphysema in 17 cases, accounting for 44.7%, pneumonia change in 6 cases, accounting for 15.8%, there were 11 cases who had lung computerized tomography examination when coming to the hospital, and only 1 case could be seen to have foreign body shadow; microscopic examination found that inhaled foreign body in the right bronchus accounted for 57.9%, and peanut was the main foreign body inhalation in this group; only 4 cases(10.5%) had definite diagnosis and foreign body removal within 24 h after foreign body aspiration, moreover, 34 cases(89.5%) with foreign body aspiration got the diagnosis and treatment after 24 h; crying was the primary inducement for inhaled foreign body.All the 38 cases of children with inhaled foreign body experienced removal under flexible bronchoscopy.There were 19 cases(50.0%) who had granulation tissue proliferation around the foreign body, among which 5 cases of foreign body was wrapped by the proliferation of granulation tissue, with APC dealing with the granulation tissue of foreign body surface to remove foreign body after exposure, then giving CO2 cryotherapy.Nevertheless, there were 9 cases of foreign body who had granulation tissue but was not wrapped, receiving CO2 cryotherapy directly after the foreign body removal.One case of this group had bradycardia during the surgery, and 2 cases had postoperative bleeding, but there was no death cases with foreign bodies removal. Conclusions Education is the key to prevent foreign body aspiration in infants under 3 years old.Flexible bronchoscopy is safe to remove foreign bodies from the respiratory tract and has fewer complications, so it is one of the alternative methods in diagnosis and treatment of foreign body inhalation. Key words: Flexible bronchoscopy; Tracheobronchial foreign body; Argon plasma coagulation; Freezing techniques; Granulation tissue; Child

Tracheobronchial foreign bodies in children - a retrospective study of 2,000 cases in Northwestern China.

The aim of this study is to report our experience in the diagnosis and treatment of tracheobronchial foreign bodies (TFBs). We retrospectively reviewed medical records of 2,000 TFB patients (1,260 males and 740 females) who were treated between January 2010 and December 2013. Chest radiography and computed tomography were performed to diagnose TFBs. The location and type of foreign bodies (FBs), anesthesia methods, and treatment outcomes and complications were analyzed. Overall, 72.5% of our patients with TFB were aged between 1 years and 3 years. Plant-based FBs are the most common FB type, accounting for 91.5%. Almost 52.1% of the FBs were encountered in the right bronchus. The coincidence rate for computed tomography-based three-dimensional reconstruction was significantly greater than that for chest X-ray examination (98.7% vs 82.0%, P<0.01). Under general anesthesia, the FBs were removed by rigid bronchoscopy. Neither anesthesia complication nor intraoperative hypoxemia occurred. There were seven deaths from acute obstructive asphyxia and eight from residual FB-induced chronic asphyxia and respiration-circulation failure. In conclusion, early diagnosis and prompt treatment of TFBs with rigid bronchoscopy under general anesthesia is effective in reducing complications and mortality in affected children.

The effects of different modes of mechanical ventilation under general anesthesia on children undergoing removal of foreign body with bronchofiberscopy

Objective To explore the effects of different ventilation modes of tracheobronchial foreign body in children with fiberoptic operation under general anesthesia. Methods Sixty children (1ys≤age≤3ys) undergoing fiberoptic bronchoscopy tracheal foreign body removal according to the combinations of different ventilation modes during and after fiberoptic bronchoscopy (FOB) procedures were divided into group A [volume control ventilation (VCV) + VCV, n= 20], group B [pressure control ventilation (PCV) + VCV, n= 20] and group C (PCV + PCV, n= 20) randomly. The P mean, P max, and PetCO2 during and after fiberoptic bronchoscopy procedures were monitored. The SpO2, PaO2, and PaCO2 after mechanical ventilation 1.5 hours were recorded. Results Compared to group A, groups B and C had lower P max and P mean (P<0.05) during the FOB procedures. Compared to groups A and B, group C had a lower P max and P mean (P<0.01) after the FOB procedures. At the 1.5 hours after the procedure, all the children showed significant increase in SpO2 and PaO2 (P<0.05) and decrease in PaCO2 (P<0.05) in groups A, B, and C. Conclusions When fiberoptic bronchoscopy in tracheobronchial foreign body operation is applied in children undergoing general anesthesia, the pressure control ventilation (VCV) mode can decrease the pressure of airway (P aw) and PaCO2 than volume control mode during procedure. Key words: Anesthesia, general; Respiration, artificial; Bronchoscopy; Foreign bodies/SU; Tracheal diseases/SU

CORP STRĂIN CU LOCALIZARE MULTIPLĂ – TRAHEE, NAS, CAVUM – LA COPIL. PREZENTARE DE CAZ

Pathology of tracheobronchial foreign bodies in children is a major emergency, because by their unpredictable evolution following mobilization, can cause sudden asphyxia. The most frequent location for airway foreign bodies is in the right primary bronchus, followed by the left primary bronchus and most rarely in the trachea. Sometimes in children, we can fi nd multiple airway foreign bodies. Very rare in children, we can fi nd airway foreign bodies with multiple location. The authors present a very rare case, unique in all pathology resolved along their quite vast experience – multiple foreign body with multiple location in the trachea, nose and cavum nasi in a child aged 1 year and 5 months.

Different anesthesia research in pediatric foreign bodies via fiberoptic bronchoscopy

Objective To investigate the clinical effect of two different anaesthesia methods in removing the tracheobronchial foreign bodies in children. Methods This was a retrospective study with 56 hospitalized children through fiberoptic bronchoscope foreign body removing since September 2010 to July 2013 in Gansu Provincial Maternity and Child-Care Hospital. All of the children whose age from 8 months to 11 years were diagnosed of tracheal-bronchial foreign body. Among 56 cases, 30 cases were operated with deep sedation anesthesia (deep sedation anesthesia group), and 26 cases with general anesthesia (general anesthesia group). The clinical effect of the two kinds of anesthesia were compared. Results The success rate of foreign bodies in deep sedation anesthesia group and general anesthesia group were 83.33% and 96.15% respectively (P>0.05), there were no statistical differences in oxygen desaturation (86.67% vs 92.31%), cyanosis (30.00% vs 26.92%), bleeding (16.67% vs 15.38%), fever (6.67% vs 3.85%), voice hoarse (40.00% vs 34.62%), vomiting (26.67% vs 19.23%), and other complications between two groups (P>0.05, respectively). There were significant differences in the rate of choking cough (11.54% vs 93.33%) and resistance (0 vs 73.33%) between general anesthesia group and deep sedation anesthesia group (P 0.05). Conclusion Compared with the deep sedation anesthesia, the success rate of removal foreign bodies is higher, and the removal foreign body time as well as comfort are all significantly improved through general anesthesia, but the average hospitalization cost and average preparation time of general anesthesia are bigger than those of deep sedation anesthesia. Key words: Bronchoscopy; Children; Tracheobronchial foreign body; Anesthesia

Tracheobronchial Foreign Bodies in Children: Imaging Assessment

Tracheobronchial foreign-body aspiration is a relatively frequent pediatric emergency and a cause of substantial morbidity and mortality especially in preschool children. Although foreign-body aspiration may cause sudden airway obstruction and subsequent death, quite often symptoms are mild and nonspecific; therefore, the correct diagnosis may be delayed particularly in the pediatric population. A delay in diagnosis increases the rate of complications and can cause substantial morbidity. Early and accurate diagnosis combined with intervention through foreign-body retrieval is critical for proper patient management. For evaluation of both radiopaque and non-radiopaque airway foreign bodies in pediatric patients, imaging plays an important role in initial detection and follow-up evaluation. In this article, we discuss the currently available imaging modalities and techniques for evaluating tracheobronchial foreign bodies in infants and children. Imaging findings of various tracheobronchial foreign bodies and mimics of foreign bodies are also discussed. In addition, information regarding management of tracheobronchial foreign-body aspiration is included.

Diagnosis and treatment of tracheobronchial foreign bodies in 1024 children

ObjectiveThis study sought to summarize the experience of diagnosis and treatment of tracheobronchial foreign bodies in children to effectively reduce complications and mortality. MethodsThe medical records of 1024 pediatric patients admitted to our hospital from January 1997 to September 2011 and diagnosed with clinically suspected tracheobronchial foreign body aspiration were retrospectively analyzed. ResultsOf the 1024 children patients, 674 were boys (65.8%) and 350 girls (34.2%). Two died of respiratory and circulatory failure (foreign bodies detected upon bronchoscopy but not retrieved) before surgery, 65 patients underwent direct bronchoscopic removal of foreign bodies due to their critical status, and 957 received chest radiographs and chest fluoroscopy or multidetector spiral computed tomographic scans (941 positive). Foreign bodies were expectorated before surgery in 3 cases. There were 953 cases of bronchoscopically proven airway foreign body aspiration, with a diagnostic accuracy of 94.5%. Ninety-eight foreign bodies were lodged in the main bronchus and/or bilateral bronchi, 506 in the right main bronchus, and 349 in the left main bronchus. Atelectasis was noted in 42 patients, including 11 with pulmonary consolidation, whose lungs were re-expanded by endobronchial lavage and sputum aspiration. In 3 patients with bronchiectasis, conservative treatment following foreign body removal was followed by no improvement, and pulmonary lobectomy was performed. Foreign bodies were successfully extracted at the first bronchoscopic attempt in 948 cases, accounting for 99.7% of the total. However, 3 patients had to undergo another bronchoscopy to remove the foreign bodies. The most common types of foreign bodies were peanuts, melon seeds, and beans. ConclusionsTimely accurate diagnosis and treatment of tracheobronchial foreign bodies in children can avoid delay in treatment and effectively reduce complications and mortality.