INTRODUCTION:
Foreign body (FB) inhalation in children has variable presentations;
from complete air way obstruction to chronic indolent cough, which
require high index of suspicion and thorough anamnestic history
[1-3]. Appropriate diagnosis and removal are important to prevent
long-term complications in those children [4].The current procedure
of choice for removal of foreign body is rigid bronchoscopy, with
potentially high rate of complications [5-7]. The complications are;
laryngeal edema, severe mucosal damage, lung atelectasis, pneumothorax,
hemorrhage. In some cases even tracheal rapture or bronchial rapture,
admission to the PICU for mechanical ventilation, cardiorespiratory
arrest, post-procedural respiratory failure and death [8-10]. During
the last decade, the indications for flexible bronchoscopy in adults and
children were expanded [11] and included foreign body removal
[12]. Among adults, the overall success of flexible bronchoscopy in
1,185 subjects (18 studies) for removal of foreign body was 89.6%
[13]. In children, the need for smaller instruments delayed this
expected process. Most of the instruments came from pediatric urology or
gastroenterology invasive procedures, thus, made the removal of FB more
feasible in the pediatric population. Until now, small studies were
published regarding the removal of FB in children by flexible
bronchoscopy, with high rate of efficacy and high safety profile [1,
14-19]. Our aim was to compare flexible to rigid bronchoscopy in the
removal of FB, regarding efficacy and safety. We further compared the
duration of the two procedures and the length of stay (LOS) in the
hospital.