Foreign body aspiration through the eyes of a pediatric pulmonologist? Is it possible to reduce the rate of negative bronchoscopies?

<bold>Background:</bold> Identifying a foreign body aspiration (FBA) still remains a diagnostic difficulty. Moreover, there is no widely agreed upon indications for performing bronchoscopy. The aim of this study was to evaluate the effectiveness of the pediatric pulmonologists in diagnosing FBA. <bold>Methods:</bold> In this retrospective study, data of children who underwent rigid bronchoscopy for suspected FBA were retracted. Patients were divided into two groups as positive for foreign body (FB+) and negative for FB (FB-). Furthermore, the patients were categorized into three groups based on their clinical scores that assessed the likelihood of the presence of FB: low, moderate and high risk. <bold>Results:</bold> Out of 474 bronchoscopies, 232 detected FB. Consultation by a pediatric pulmonologist was not requested in 388 (81.8%). Out of 388 patients, 206 (53%) were FB-. In terms of FB detection success, there was no difference between individuals who sought pulmonology consultation and those who did not (p= 0.059). However, when children were categorized into risk levels, the incidence of FB in low-risk group was 42% when they received consultation from pulmonology, among contrast, this incidence dropped to 5.6% when pulmonology consultation was not sought(p< 0.001). In addition, negative bronchoscopy rate was 94.4% when not consulted with pediatric pulmonology. <bold>Conclusions:</bold> While both pediatric pulmonologists and pediatric surgeons have comparable rates of accurately predicting FB when considering the entire population, seeking consultation from a pediatric pulmonologist especially in the low-risk group may decrease the occurrence of negative bronchoscopy.