Comparison of direct vision and video imaging during bronchoscopy for pediatric airway foreign bodies.
Rigid ventilation bronchoscopy is a most useful means of detecting and removing foreign bodies in the airway. We performed a retrospective study of 114 children who had undergone such a procedure during a 12-year period. During bronchoscopy, 48 of these patients had been examined under direct vision and 66 by videotape recording. We found that the positive rate on first-look direct vision was 93.8% and the positive rate on first-look video imaging was 89.4%. The lower positive rate during the first-look examination by video imaging might be attributable to the facts that it is safer and that it provides a better visual field, which can encourage operators to choose video ventilation bronchoscopy, either as a diagnostic or therapeutic tool. In addition, three foreign-body-negative patients in the direct-vision group under-went a second procedure, and a foreign body was found in all three. Only one of the video-imaging patients under-went a second procedure, and no foreign body was found. The difference in the positive rates after the second procedure was statistically significant (p < 0.05). This might be attributable to the higher success rate with video imaging following the first procedure, which significantly reduced the need for a second look and the possibility of overlooked or residual foreign bodies. The condition of the mucosa postprocedurally was described in every case after video imaging but after only 41.7% of the direct-vision cases--a statistically significant difference (p < 0.001). Video imaging provides the physician with a clear, magnified view of the area under examination. It allows for later review of the videotape when necessary, and it reduces the risk that residual foreign-body material will remain in the airway.
Yang
Cheng-Chien
CC
Department of Otolaryngology-Head and Neck Surgery, Mackay Memorial Hospital, 92, Chung-Shan North Rd. Sec. 2, Taipei 10449, Taiwan.
Lee
Kuo-Sheng
KS
D001999:Bronchoscopy / Q000379:methods*; D002675:Child, Preschool; D005260:Female; D005547:Foreign Bodies / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012137:Respiratory System; D012189:Retrospective Studies; D020535:Video-Assisted Surgery