Hostname: page-component-78c5997874-8bhkd Total loading time: 0 Render date: 2024-11-10T10:42:21.926Z Has data issue: false hasContentIssue false
  • English
  • Français

Role of virtual bronchoscopy in children with a vegetable foreign body in the tracheobronchial tree

Published online by Cambridge University Press:  12 November 2014

G Behera ,
N Tripathy ,
Y K Maru ,
R K Mundra ,
Y Gupta  and
M Lodha
G Behera*
Affiliation:
Department of ENT and Head Neck Surgery, Lokmanya Tilak Medical College, Mumbai, India
N Tripathy
Affiliation:
Department of ENT and Head Neck Surgery, Lokmanya Tilak Medical College, Mumbai, India
Y K Maru
Affiliation:
Department of ENT and Head Neck Surgery, Mahatma Gandhi Memorial Medical College and Maharaj Yashwant Hospital, Indore, India
R K Mundra
Affiliation:
Department of ENT and Head Neck Surgery, Mahatma Gandhi Memorial Medical College and Maharaj Yashwant Hospital, Indore, India
Y Gupta
Affiliation:
Department of ENT and Head Neck Surgery, Mahatma Gandhi Memorial Medical College and Maharaj Yashwant Hospital, Indore, India
M Lodha
Affiliation:
Piramal Diagnostic Centre, Indore, India
*
Address for correspondence: Dr G Behera, Department of ENT and Head Neck Surgery, Lokamanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai-22, Maharashtra, India Fax: E-mail: drganakalyan@gmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives:

Multidetector computed tomography virtual bronchoscopy is a non-invasive diagnostic tool which provides a three-dimensional view of the tracheobronchial airway. This study aimed to evaluate the usefulness of virtual bronchoscopy in cases of vegetable foreign body aspiration in children.

Methods:

The medical records of patients with a history of foreign body aspiration from August 2006 to August 2010 were reviewed. Data were collected regarding their clinical presentation and chest X-ray, virtual bronchoscopy and rigid bronchoscopy findings. Cases of metallic and other non-vegetable foreign bodies were excluded from the analysis. Patients with multidetector computed tomography virtual bronchoscopy showing features of vegetable foreign body were included in the analysis. For each patient, virtual bronchoscopy findings were reviewed and compared with those of rigid bronchoscopy.

Results:

A total of 60 patients; all children ranging from 1 month to 8 years of age, were included. The mean age at presentation was 2.01 years. Rigid bronchoscopy confirmed the results of multidetector computed tomography virtual bronchoscopy (i.e. presence of foreign body, site of lodgement, and size and shape) in 59 patients. In the remaining case, a vegetable foreign body identified by virtual bronchoscopy was revealed by rigid bronchoscopy to be a thick mucus plug. Thus, the positive predictive value of virtual bronchoscopy was 98.3 per cent.

Conclusion:

Multidetector computed tomography virtual bronchoscopy is a sensitive and specific diagnostic tool for identifying radiolucent vegetable foreign bodies in the tracheobronchial tree. It can also provide a useful pre-operative road map for rigid bronchoscopy. Patients suspected of having an airway foreign body or chronic unexplained respiratory symptoms should undergo multidetector computed tomography virtual bronchoscopy to rule out a vegetable foreign body in the tracheobronchial tree and avoid general anaesthesia and invasive rigid bronchoscopy.

Keywords

Foreign bodiesMultidetector Computed TomographyBronchoscopyTracheaBronchi
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 128 , Issue 12 , December 2014 , pp. 1078 - 1083
Copyright
Copyright © JLO (1984) Limited 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Sinha, V, Memon, R, Gupta, D, Prajapati, B, Bhat, V, More, Y. Foreign body in tracheobronchial tree. Indian J Otolaryngol Head Neck Surg 2007;59:211–14CrossRefGoogle ScholarPubMed
2Kaur, K, Sonkhya, N, Bapna, AS. Foreign bodies in the tracheobronchial tree: A prospective study of fifty cases. Indian J Otolaryngol Head Neck Surg 2002;54:29–34Google Scholar
3Schimpl, G, Weber, G. Foreign body aspiration in children, the advantages of emergency endoscopy and foreign body removal. Anaesthesist 1991;40:479–82Google ScholarPubMed
4Kohli, GS, Verma, PL. Overlooked foreign body of subglottic region. Indian J Otolaryngol Head Neck Surg 1969;21:85–7Google Scholar
5Sorantin, E, Geiger, B, Lindbichler, F, Eber, E, Schimpl, G. CT based virtual tracheobronchoscopy in children—comparison with axial CT and multiplanar reconstruction preliminary results. Pediatr Radiol 2002;32:8–15Google Scholar
6Prasad, BG. Changes proposed in social classification of Indian families. J Indian Med Assoc 1970;55:198–9Google Scholar
7Applegate, KE, Dardinger, JT, Lieber, ML, Herts, BR, Davros, WJ, Obuchowski, NA et al. Spiral CT scanning technique in the detection of aspiration of LEGO foreign bodies. Pediatr Radiol 2001;31:836–40Google Scholar
8Metrangolo, S, Monetti, C, Meneghini, L, Zadra, N, Giusti, F. Eight years experience with foreign body aspiration in children: what is really important for a timely diagnosis? J Pediatr Surg 1999;34:1229–31Google Scholar
9Zissin, R, Shapiro-Feinberg, M, Rozenman, J, Smorjik, J, Hertz, M. CT findings of the chest in adults with aspirated foreign bodies. Eur Radiol 2001;11:602–11Google Scholar
10Tan, HKK, Brown, K, McGill, T, Kenna, MA, Lund, DP, Healy, GB. Airway foreign bodies (FB): a 10-year review. Int J Pediatr Otorhinolaryngol 2000;56:91–9CrossRefGoogle Scholar
11Mu, L, Sun, D, He, P. Radiologic diagnosis of aspirated foreign bodies in children: review of 343 cases. J Laryngol Otol 1990;104:778–82Google Scholar
12Burton, EM, Brick, WG, Hall, JD, Riggs, W Jr, Houston, CS. Tracheobronchial foreign body aspiration in children. South Med J 1996;89:195–8Google Scholar
13Zerella, JT, Dimler, M, McGill, LC, Pippus, KJ. Foreign body aspiration in children: value of radiography and complications of bronchoscopy. J Pediatr Surg 1998;33:1651–4Google Scholar
14Dunn, GR, Wardrop, P, Lo, S, Cowan, DL. Management of suspected foreign body aspiration in children. Clin Otolaryngol 2002;27:384–6Google Scholar
15Grenier, PA, Beigelman-Aubry, C, Fetita, C, Preteux, F, Braener, MW, Lenoir, S. New frontiers in CT imaging of airway disease. Eur Radiol 2002;12:1022–44CrossRefGoogle ScholarPubMed
16McAdams, HP, Palmer, SM, Erasmus, JJ, Patz, EF, Connolly, JE, Goodman, PC et al. Bronchial anastomotic complications in lung transplant recipients: virtual bronchoscopy for noninvasive assessment. Radiology 1998;209:689–95Google Scholar
17Sodhi, KS, Saxena, AK, Singh, M, Rao, KLN, Khandelwal, N. CT virtual bronchoscopy: new non invasive tool in pediatric patients with foreign body aspiration. Indian J Pediatr 2008;75:511–13Google Scholar
18Bhat, KV, Hegde, JS, Nagalotimath, US, Patil, GC. Evaluation of computed tomography virtual bronchoscopy in paediatric tracheobronchial foreign body aspiration. J Laryngol Otol 2010;124:875–9Google Scholar
19Kosucu, P, Ahmetoglu, A, Koramaz, I, Orhan, F, Ozdemir, O, Dinc, H et al. Low-dose MDCT and virtual bronchoscopy in pediatric patients with foreign body aspiration. AJR Am J Roentgenol 2004;183:1771–7CrossRefGoogle ScholarPubMed
20Haliloglu, M, Ciftci, AO, Oto, A, Gumus, B, Tanyel, FC, Senocak, ME et al. CT virtual bronchoscopy in the evaluation of children with suspected foreign body aspiration. Eur J Radiol 2003;48:188–92Google Scholar
21Kocaoglu, M, Bulakbasi, N, Soylu, K, Demirbag, S, Tayfun, C, Somuncu, I. Thin section axial multidetector computed tomography multiplanar reformatted imaging of children with suspected foreign-body aspiration: is virtual bronchoscopy overemphasized? Acta Radiol 2006;47:746–51Google Scholar
22Summers, RM, Shaw, DJ, Shelhamer, JH. CT virtual bronchoscopy of simulated endobronchial lesions: effect of scanning, reconstruction and display setting and potential pitfalls. AJR Am J Roentgenol 1998;170:947–50Google Scholar
23Mahyar, A, Tarlan, S. Foreign bodies aspiration in children. Acta Medica Iranica 2008;46:115–19Google Scholar