Rigid Bronchoscopy for Foreign Body Removal in the Paediatric Airway: A Single-Center Perspective

Aims & Objectives: To assess the epidemiological, clinical, radiological and endoscopic features of inhaled foreign bodies in children and the outcome following removal using rigid bronchoscopy. Methods: This was a retrospective surveillance study conducted in the department of Paediatric Surgery of JSS Hospital, Mysore from January 2019 to September 2024. Children presented with clinical/radiological features suggestive of foreign body aspiration and underwent rigid bronchoscopy were included in the study. Demographic characteristics, presenting symptoms and its duration, examination and radiological findings, and outcome of bronchoscopy were analysed by descriptive statistical methods. Results: 47 children (30 males and 17 females) underwent rigid bronchoscopy for suspicion of foreign body inhalation. They were aged from 6 months to 15 years out of which 35 (74.4%) were less than 3 years of age. Choking was the most frequently reported symptom in 23 (48.9%) cases, followed by noisy breathing, cough, and pneumonia all show the same frequency of 15 (31.9%). Delay between aspiration and removal was 1-15 days in 24 (51.06%) children and within 24 h in 15 (31.91%) children. The examination was normal in 6 (12.76%) children. The majority of the X-rays (51.1%) showed a normal finding followed by ipsilateral hyperinflation, consolidation and collapse in 29.8%, 6.4% and 4.3% respectively. Most common foreign body aspirated was peanuts (38.29%), and 74.5% was organic material. The foreign body was mostly lodged in right main bronchus (46.8%), followed by the left main bronchus (25.5%) and the trachea (14.9%). Procedure was successful in 91.48%, while no foreign body was noted in 8.51%. Total or partial failure of retrieval of foreign body was noted only in two children (4.3%). Conclusion: These findings highlight the need for early diagnosis and high clinical suspicion in children presenting with features suggestive of foreign body aspiration. Public health initiatives should focus on parental education regarding reduction of risks and early presentation to hospital.