Foreign-body aspiration into the lower airways in adults; multicenter study

• Published in: PloS one Vol. 17; no. 7; p. e0269493
• Main Authors: Jang, Gimun, Song, Jae Woon, Kim, Hyun Jung, Kim, Eun Jin, Jang, Jong Geol, Cha, Seung-Ick
• Format: Journal Article
• Language: English
• Published: San Francisco Public Library of Science 06-07-2022; Public Library of Science (PLoS)
• Subjects: Adults; Aging; Anesthesia; Aspiration and aspirators; Biology and Life Sciences; Bronchoscopy; Bronchus; Comorbidity; Consciousness; Disabilities; Evaluation; Fainting; Foreign bodies; Health aspects; Health risks; Medical imaging; Medicine and Health Sciences; Neuromuscular diseases; Nuts; Ostomy; Paresis; Parkinson's disease; Patients; Pneumonia; Research and Analysis Methods; Teeth; South Korea
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0269493

Foreign-body aspiration is common in children aged 6 months to 3 years. However, with the aging population and increasing prevalence of disabilities such as hemiparesis and neuromuscular diseases in adults, an increased incidence of aspiration is expected. This was a multicenter retrospective, observational study in four major referral hospitals in Daegu, South Korea, between 2000 and 2019. We included patients aged over 18 years who were evaluated for tracheobronchial foreign-body aspiration by flexible bronchoscopy. Comorbidities, type and location of foreign body, and radiologic findings were recorded. Of 138 patients who underwent flexible bronchoscopy for tracheobronchial foreign body aspiration, 91 (65.9%) were men; the mean age was 66.3 (range: 29-87) years. A history of definite choking was present in 60 (43.5%) patients. The most common site of the foreign body was the right bronchus intermedius (27.5%). The most common type of aspirated foreign body was teeth (37.7%), followed by chicken bone (15.2%), nuts (14.5%) and fish bone (9.4%). Iatrogenic events accounted for 37.0% of the cases of aspiration, and the foreign body was successfully removed by flexible bronchoscopy in 91.3% of cases. Foreign-body aspiration is not rare, even in adults who do not have predisposing factors. Iatrogenic events accounted for about 40% of all cases of foreign body aspiration. In adults, flexible bronchoscopy is relatively safe and has a high success rate for foreign-body removal.