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.