Novel use of a balloon for bronchial bead foreign body removal

Video Type: CVideo
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Author: Sean Chislett
Published:
Specialties: Otolaryngology, Pediatric Surgery
Schools: Madigan Army Medical Center, Seattle Childrens Hospital
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Basic Info

Contributors: Josephine Czechowicz and Sanjay Parikh

Removal of a bronchial foreign body with a smooth surface can be challenging with standard optical forceps. The fogarty arterial embolectomy catheter is a suitable alternative, particularly in the setting of a bead or other hollow object.

DOI: http://dx.doi.org/10.17797/7gq2gil0v3

Editor Recruited by: Sanjay Parikh

Advanced

Procedure

Rigid bronchoscopy and foreign body removal with a Fogarty balloon catheter.

Indications

Bronchial bead foreign body.

Contraindications

Unstable cervical spine, inability to open mouth, or significant glottic or subglottic stenosis.

Instrumentation

Setup

Total intravenous anesthesia with spontaneous ventilation, topical lidocaine, rigid bronchoscope attached to anesthesia circuit.

Preoperative Workup

History and physical including lung auscultation, chest x-ray.

Anatomy and Landmarks

Larynx, trachea, right and left mainstem bronchi.

Advantages/Disadvantages

Advantages: fast and secure removal.
Disadvantages: only ideal for certain foreign body shapes.

Complications/Risks

Bleeding, airway edema, need for intubation.

Disclosure of Conflicts

Bleeding, airway edema, need for intubation.

Acknowledgements

None.

References

1. Digoy GP. Diagnosis and management of upper aerodigestive tract foreign bodies. Otolaryngol Clin North Am. 2008 Jun;41(3):485-96, vii-viii.
2. Elsharkawy H, Abd-Elsayed AA, Karroum R. Management challenges in the passing-through technique using a fogarty catheter to remove an endobronchial foreign body from an infant. Ochsner J. 2015 Spring;15(1):110-3.
3. Good GM, Deutsch ES. Method for removing endobronchial beads. Ann Otol Rhinol Laryngol. 1998 Apr;107(4):291-2.

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