Management of tracheobronchial foreign bodies in a Nigerian tertiary health center

Abstract

Background: Airway foreign bodies present as emergencies, are not uncommon in developing countries like Nigeria, and can occur in all age groups. They present great difficulties for both parents and medical practitioners in general and the otorhinolaryngologist in particular. Tracheobronchial foreign bodies may endanger the life of the patient depending on the type, size, and location of the foreign body in the airway tract. We aim to look at the management of tracheobronchial foreign bodies and present a maiden article on the management of tracheobronchial foreign bodies in our center. Patients and Methods: This was a retrospective review of all patients seen at the Emergency Unit and Consultant Clinics of the National Ear Care Centre, Kaduna, Nigeria, with diagnosis of foreign bodies in the airway (the tracheobronchial area). Medical records of patients seen between January 1, 2012, and December 31, 2016, were reviewed. Data generated from the case files were analyzed descriptively. Results: Thirty-four patients presented with foreign bodies in the airway. This comprises 25 males and 9 females in a ratio of 2.8:1. Age at presentation ranged between 11 months and 27 years; the mean age was 7.02 ± 5.46 years. The predominant age group affected was 0–9 years. Twelve patients had a preliminary tracheostomy before endoscopic removal of the foreign body. Twenty-seven patients had rigid bronchoscopy and foreign body removal while 3 patients had flexible bronchoscopy, 1 patient had direct laryngoscopy, and 3 patients had tracheoscopy and foreign body removal. Majority of the foreign bodies were plastic in origin. Conclusion: Airway foreign bodies are acute emergencies, especially in pediatric age groups, and the best modality of treatment is endoscopic removal under general anesthesia.