The evaluation of children with suspected airway foreign bodies and the association with viral illness

Introduction

Foreign body aspiration (FBA) is a common and potentially life-threatening event in young children. While literature emphasizes management, less is known about potential risk factors. The authors hypothesized that viral upper respiratory infections (URIs) increase the risk of FBA and aimed to describe the clinical spectrum, outcomes, and complications of pediatric airway FBA.

Methods

The authors conducted a single-institution retrospective study through review of electronic medical records for all patients under 18 years of age who underwent endoscopic procedures for presumed airway foreign body between 2017 and 2022 at a quaternary children's hospital.

Results

Eighty patients were included in the study. Thirty-four (46 %) of the retrieved FBs were food particles. Nineteen (24 %) of the patients with FBA had caregiver reports of URI symptoms and three (7 %) of the FBA patients also had positive viral panels. Of the six patients who did not have a FB present, two had caregiver reports of URI symptoms prior to surgery, and two additional patients had positive viral panels at the time of presentation. Only three patients without FB had evidence of airway inflammation on endoscopic findings (edema or increased secretions). Sixty-six of the 74 (89 %) patients with FBA had abnormal chest radiographic findings on plain film imaging.

Conclusion

Concern for an association between URI and an increased risk of FBA amongst pediatric patients was not supported by this analysis. Further prospective studies with multi-center, standardized data collection would be helpful to further characterize this relationship and guide counseling for parents.