title: Long-standing inhaled foreign bodies in children: Characteristics and outcome.
abstract: OBJECTIVE
  Aspirated foreign bodies in children present a potentially life-threatening condition and can be challenging to diagnose. This study aims to elucidate the characteristics and outcome of children with long-standing aspirated foreign bodies.
  
  
  METHODS
  Retrospective case series of all cases of confirmed long-standing aspirated foreign bodies (LSAFB) between January 2003 to December 2015 in a single paediatric tertiary-level institution, defined as more than two weeks from choking episode or beginning of symptoms.
  
  
  RESULTS
  Clinical files and operative records on 227 patients were screened and 35 children were confirmed to have been treated for LSAFB as per definition above. Median time to presentation was 4 weeks (mean 8.8 weeks). Eighty-six percent presented with cough and 51% with dyspnoea. Abnormal chest X-ray findings were found in 28 out 31 patients (90%). Organic foreign bodies (22) were more common than inorganic (14). Intraoperative granulation tissue was demonstrated in 89% of patients and in 46% of patients this was regarded as significant (defined as obstructing more than 50% of the involved airway lumen). Mean length of stay was 2.5 days. Nine patients (26%) had 11 respiratory complications; there were no mortalities.
  
  
  CONCLUSIONS
  Paediatric LSAFB poses an uncommon diagnostic dilemma as there is often no witnessed history of aspiration event; and signs, symptoms and chest X-Ray findings are often non-specific. Laryngobronchoscopy is made more difficult by the presence of granulation tissue and the sequelae of prolonged non-treatment is a higher rate of chronic respiratory disease.
authors.affiliation: Starship Children's Hospital, Auckland, New Zealand.
authors.forename: Andrew
authors.initials: A
authors.lastname: Martin
authors.affiliation: Starship Children's Hospital, Auckland, New Zealand.
authors.forename: Graeme
authors.initials: G
authors.lastname: van der Meer
authors.affiliation: Starship Children's Hospital, Auckland, New Zealand.
authors.forename: Dora
authors.initials: D
authors.lastname: Blair
authors.affiliation: Starship Children's Hospital, Auckland, New Zealand.
authors.forename: Murali
authors.initials: M
authors.lastname: Mahadevan
authors.affiliation: Starship Children's Hospital, Auckland, New Zealand.
authors.forename: Michel
authors.initials: M
authors.lastname: Neeff
authors.affiliation: Starship Children's Hospital, Auckland, New Zealand.
authors.forename: Colin
authors.initials: C
authors.lastname: Barber
authors.affiliation: Starship Children's Hospital, Auckland, New Zealand.
authors.forename: Nicola
authors.initials: N
authors.lastname: Mills
authors.affiliation: Starship Children's Hospital, Auckland, New Zealand.
authors.forename: Lesley
authors.initials: L
authors.lastname: Salkeld
authors.affiliation: Starship Children's Hospital, Auckland, New Zealand; Otolaryngology Department, Naharia West Galilee Medical Centre, Naharia, Israel. Electronic address: maayan_gr@yahoo.com.
authors.forename: Maayan
authors.initials: M
authors.lastname: Gruber
mesh_terms: D000293:Adolescent; D001980:Bronchi / Q000000981:diagnostic imaging* / Q000601:surgery; D001999:Bronchoscopy; D002648:Child; D002675:Child, Preschool; D003371:Cough / Q000209:etiology*; D004417:Dyspnea / Q000209:etiology*; D005260:Female; D005547:Foreign Bodies / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D006097:Granulation Tissue; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007828:Laryngoscopy; D007830:Larynx / Q000000981:diagnostic imaging* / Q000601:surgery; D008297:Male; D009520:New Zealand; D013902:Radiography, Thoracic; D053120:Respiratory Aspiration; D012135:Respiratory Sounds / Q000209:etiology*; D012189:Retrospective Studies; D013997:Time Factors; D014132:Trachea / Q000000981:diagnostic imaging* / Q000601:surgery
keywords: Airway; Aspirated foreign body; Cough; Paediatric; Pneumonia