Asthma and Foreign Body Aspiration

Abstract

Objective: Determine the prevalence of asthma in children who underwent rigid bronchoscopy (RB) for a suspected foreign body aspiration (sFBA) in the tracheobronchial tree, and to identify characteristics of patients who could benefit from a trial of anti-asthma treatment prior to undergoing a diagnostic bronchoscopy.

Method: Retrospective chart review of children with sFBA in the tracheobronchial tree who underwent RB at the Montreal Children’s Hospital (2001-2009). Patient characteristics such as delay between initial choking episode and first otolaryngology evaluation, clinical findings, radiologic findings, bronchoscopic findings, and history of asthma were analyzed.

Results: A total of 55 children underwent a RB for sFBA. Foreign bodies (FB) were found in 36 of these, one of which was asthmatic (2.78%, P < .05). In the 19 children who had a negative bronchoscopy (no FB), four were asthmatics (21.1%, P < .05). The mean time from the suspected initial choking event to the first otolaryngology evaluation was 27 days in asthmatics (range, 5 hours-90 days; median, 14 days), whereas it was 7.2 days in nonasthmatics (range, 0.5 hours-120 days; median, 16 hours). Otherwise, clinical and radiological findings were not significantly different in the asthmatic and non-asthmatic groups.

Conclusion: Asthmatic children with sFBA are significantly more likely to have a negative bronchoscopy than non-asthmatics, especially when there is a delay between the suspected choking episode and the first otolaryngology evaluation. Therefore, a trial of anti-asthma treatment prior to performing a diagnostic bronchoscopy in this subgroup of patients is justified.