Inhalation of foreign bodies in Chinese children: a review of 400 cases.
A retrospective review of 400 Chinese children who had inhaled foreign bodies was undertaken. There has been a yearly increase in the total number of cases of airway foreign bodies removed in our hospital. Fifty-eight percent of the children presenting were from the countryside; 42% were townspeople. Approximately 90% of the patients were under 3 years of age, with the peak incidence of foreign body inhalation occurring between 1 and 2 years of age (57.8%). The male-female ratio was about 1.2:1. About 95% of the removed foreign bodies were organic in origin. The majority of the foreign bodies were found most often in the right bronchial tree (46%). A positive history of foreign body inhalation was obtained in 98% of the cases. Twenty-eight percent of the children presented at the hospital within 24 hours, 71% within 1 week, and 29% more than 1 week after inhaling the foreign body. The most common presenting symptoms of laryngotracheal foreign bodies were cough, wheezing, dyspnea, and hoarseness; those of bronchial foreign bodies were cough, wheezing, decreased air entry, and rhonchi. More than two-thirds of the children with larygotracheal foreign bodies had normal x-ray findings. The most common fluoroscopic findings in those children with bronchial foreign bodies were mediastinal shift (36.8%), obstructive emphysema (35.7%), and normal findings (35%). A total of 348 (87%) bronchial foreign bodies were removed by rigid bronchoscopy (81%), rod-lens bronchoscopy (5%), and spontaneous expulsion (1%); 52 (13%) laryngeal and tracheal foreign bodies were removed by direct laryngoscopy (12%) and tracheotomy (1%). A single endoscopic procedure successfully removed 92.5% of 400 foreign bodies detected in the airways. One child died during bronchoscopy, for a mortality rate of 0.25%.
Mu
L
L
Department of Otolaryngology, 3rd Affiliated Hospital, China Medical University, Shenyang, Liaoning.
He
P
P
Sun
D
D
D000293:Adolescent; D000367:Age Factors; D001980:Bronchi; D002648:Child; D002675:Child, Preschool; D005260:Female; D005547:Foreign Bodies / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D007223:Infant; D001239:Inhalation; D008297:Male; D012737:Sex Factors