Bronchoscopy for Removal of Aspirated Tracheobronchial Foreign Bodies at Kenyatta National Hospital, in Kenya
AbstractBackground: This study was aimed at defining the presentation, morbidity and mortality following inhalation and subsequent removal of tracheobronchial foreign body using a rigid bronchoscope.
Methods: This was a retrospective, cross-sectional study undertaken in the Ear Nose and Throat-Head and Neck Surgery Unit of Kenyatta National Hospital. The study population consisted of patients with brochoscopically proven tracheobronchial foreign body. Case notes of 107 consecutive admissions with brochoscopically verified tracheobronchial foreign bodies
were analyzed for age, sex, time interval between inhalation and removal, duration of stay in hospital, complications and mortality.
Results: The vast majority of patients were below 3 years of age and 63% of them presented within 3 days after onset of symptoms. The right bronchus was the most frequent destination of inhaled foreign bodies (50.5%) followed by the left bronchus (17.8%) and carina (14.2%) in
that order. The turnover of patients with inhaled foreign bodies was high with 86.9% being discharged within 6 days after surgery. The bronchoscopic procedure was uneventful in 76.6% of patients. Repeat bronchoscopy was performed in three patients with one undergoing eventual thoracotomy.
Intraoperative cardiac arrest occurred in 5 cases (4.6%) with successful resuscitation in 2 and mortality in three (2.7%) % cases.
Conclusion: Bronchoscopic removal of inhaled foreign bodies remains one of the riskiest otolaryngologic emergencies in Kenyatta National Hospital partly because of involvement of the life sustaining airway and partly because of lack of ideal equipment and adequate expertise. The need for hands on experience and close cooperation and familiarity between the
anaesthesiologist and the bonchoscopist is emphasized.