Thoracotomy for Bronchial Foreign Bodies: A Propos of 3 Cases

Objective: To report 3 cases of bronchial foreign bodies removed by thoracotomy
Patients and Methods: Retrospective study was conducted from January 1st 2005 to December 31 2011 in the ENT Clinic of NTH of Fann. During this 7-year period, 96 cases of foreign bodies of lower respiratory tract were managed with 63 cases of bronchial location. Bronchoscopic removal was achieved in 60 cases but failed in 3 cases. Removal of bronchial foreign bodies was finally performed through thoracotomy.
Results: In 3% (3/96 cases), thoracotomy was performed. The patients were 5, 8 and 12 years old. The foreign bodies were non organic (nail, pearl, dolphin-like hair styling accessory). Chest X-ray showed one case of radiolucent object. Bronchoscopic removal failed twice or 3 times, in each case. Therefore, external thoracic surgery was done: 2 bronchotomies and 1 right posterior inferior lobectomy. Posterior lateral thoracic incision was used. No complication occurred.
Conclusion: Bronchoscopy remains the gold standard treatment in the management of airway foreign bodies. Because of recent technological improvements in instrumentation, external thoracic surgery is avoided.