Extraction of large tracheal foreign bodies through a tracheostoma under bronchoscopic control.
Despite various technical manipulations through contemporary endoscopic equipment, large tracheal foreign bodies may be lost during bronchoscopic extraction, with a 1 to 2% in-hospital mortality. Recently, emergency tracheostomy was performed during bronchoscopy after a tracheal foreign body had become dislodged in the subglottic region causing blockage of the airway, and the results of this procedure provoked its deliberate application in a second patient. In 3 additional infants, aspirated tracheal T tubes (Montgomery tubes), which were producing acute respiratory distress, were brought from the carina to the performed tracheostoma under bronchoscopic manipulation and were withdrawn. Elective application of this simultaneous approach--tracheostomy with bronchoscopy--may decrease morbidity and mortality from large tracheal foreign bodies.
D000402:Airway Obstruction / Q000209:etiology / Q000601:surgery; D001999:Bronchoscopy; D005547:Foreign Bodies / Q000150:complications / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D014132:Trachea; D014140:Tracheotomy