title: Tracheobronchial foreign body removal in infants who had very small airways: A prospective clinical trial.
abstract: OBJECTIVE
  Tracheobronchial foreign body aspiration is a life-threatening emergency. Using a rigid bronchoscope with optical forceps is the most effective method for foreign body removal. However, occasionally for some infants these instruments could not be used, as they may be too large for their small airways. Here, they present the apnea technique with only an optical forceps for foreign body removal in infants with very small airways.
  
  
  METHODS
  Foreign bodies were removed using only an optical forceps for infants who had very small diameter airways. After general anesthesia, the suspension laryngoscope was set just above the vocal cord, and the inserted ventilation tube was pulled out, followed by a new one being inserted through the suspension laryngoscope and placed at the trachea. With the oxygen saturation at 100%, we pulled out the ventilation tube and inserted the optical forceps with an endoscope. After that, the foreign body was removed by the optical forceps.
  
  
  RESULTS
  The foreign body removal using only an optical forceps is technically feasible for an infant. The mean operation time was 40.33 ± 8.06 min, and the hospital stay was 2.25 ± 0.62 days. When we pulled out the ventilation tube, the O2saturation mean time (apnea time) was 106.25 ± 14.30 sec. In 12 infants, the foreign body was removed completely without a need for a second procedure.
  
  
  CONCLUSIONS
  The apnea technique for the removal of foreign body from the airway, using only an optical forceps with an endoscope, is useful in infants who had very small airways.
authors.affiliation: Department of Otolaryngology, Institute of Health Sciences, Gyeongsang National University, Jinju, South Korea.
authors.forename: Seung Hoon
authors.initials: SH
authors.lastname: Woo
authors.affiliation: Department of Otolaryngology, Institute of Health Sciences, Gyeongsang National University, Jinju, South Korea.
authors.forename: Jung Je
authors.initials: JJ
authors.lastname: Park
authors.affiliation: Department of Otolaryngology, Institute of Health Sciences, Gyeongsang National University, Jinju, South Korea.
authors.forename: Minsu
authors.initials: M
authors.lastname: Kwon
authors.affiliation: Head and Neck Oncology Clinic, National Cancer Center, Ilsan, South Korea.
authors.forename: Jun Sun
authors.initials: JS
authors.lastname: Ryu
authors.affiliation: Department of Otolaryngology, Institute of Health Sciences, Gyeongsang National University, Jinju, South Korea.
authors.forename: Jin Pyeong
authors.initials: JP
authors.lastname: Kim
mesh_terms: D000367:Age Factors; D000402:Airway Obstruction / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D001980:Bronchi; D001999:Bronchoscopy / Q000379:methods*; D005260:Female; D005547:Foreign Bodies / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D061646:Operative Time; D056888:Patient Positioning; D011446:Prospective Studies; D020127:Recovery of Function; D018570:Risk Assessment; D014057:Tomography, X-Ray Computed / Q000379:methods; D014132:Trachea; D016896:Treatment Outcome
keywords: airway; bronchoscopy; endoscopes; foreign bodies; infants