Çocuklarda Yabancı Cisim Aspirasyonu Zaman Duyarlıdır: 79 Olgunun Retrospektif Analizi

Yıl 2025, Cilt: 6 Sayı: 2, 103 - 110, 20.05.2025

Mehmet Çetin , Sebahattin Sefa Ermancık , Necati Solak , Fatma Şule Erdem , Engin Zafer Terzi , Can Kutlay , Büşra Özdemir Çiflik , İlteriş Türk , Koray Aydoğdu

https://doi.org/10.47482/acmr.1634056

Öz

Arka Plan: Yabancı cisim aspirasyonu (YCA), özellikle 1-3 yaş aralığındaki çocuklarda önemli bir morbidite ve mortalite nedenidir. Bronkoskopi, YCA öyküsü şüphesi olan hastalarda altın standart tanı yöntemidir ve aynı zamanda birincil tedavi yöntemidir.
Yöntemler: Aralık 2023 ile Aralık 2024 arasında YCA şüphesi olan pediatrik hastaları değerlendirdik. Aspirasyon olasılığı olan tüm hastalara bronkoskopi önerildi ve işleme razı olanlara laringeal maske altında fiberoptik bronkoskopi (FOB) yapıldı.
Bulgular: 43 hastada (%54,4) yabancı cisim tespit edildi. Yabancı cisim çıkarılması 2 hastada (%2,6) FOB, 40 hastada (%50,6) rijit bronkoskopi ve 1 hastada (%1,3) torakotomi ile yapıldı. Organik kökenli YC, okul öncesi döneme kıyasla okul sonrası döneme göre önemli ölçüde yüksekti (p=0,004). Aspirasyon ile girişimsel işlem arasındaki medyan aralık, granülasyon dokusu gelişimi olan ve olmayan FBA vakalarında sırasıyla 8 (min: 5 - maks: 45) ve 2 (min: 0 - maks: 61) gündü. Aspirasyon ile girişimsel işlem arasındaki medyan aralık, granülasyon dokusu gelişenlerde anlamlı derecede daha uzundu (p=0,002).
Sonuçlar: FBA çocukluk çağında önemli bir sağlık sorunudur ve morbidite ve mortaliteye yol açabilir. Komplikasyonları önlemek için FBA için işlem yapan merkezlerin çeşitlendirilmesi ve işlemlerin birden fazla merkezde yapılması gerekmektedir.

Anahtar Kelimeler

Bronkoskopi , çocukluk çağı , yabancı cisim aspirasyonu

Foreign Body Aspiration in Children is Time-Sensitive: A Retrospective Analysis of 79 Cases

Öz

Background: Foreign body aspiration (FBA) is an important cause of morbidity and mortality in children, especially within the 1-3 year age range. Bronchoscopy is the gold standard diagnostic method in patients with a suspected history of FBA and is also the primary treatment.
Methods: We evaluated pediatric patients who presented with suspected FBA between December 2023 and December 2024. Bronchoscopy was recommended for all patients who might have aspiration, and fiberoptic bronchoscopy (FOB) was done under a laryngeal mask on those who agreed to the procedure.
Results: A foreign body was identified in 43 patients (54.4%). Foreign body extraction was performed by FOB in 2 (2.6%), rigid bronchoscopy in 40 (50.6%), and thoracotomy in 1 (1.3%) of the patients. FBA of organic origin was considerably elevated before schooling compared to post-schooling (p=0.004). The median interval between aspiration and interventional procedure was 8 (min: 5 - max: 45) and 2 (min: 0 - max: 61) days in FBA cases with and without granulation tissue development, respectively. The median interval between aspiration and interventional procedure was significantly longer in those who developed granulation tissue (p=0.002).
Conclusions: FBA is an important health issue in childhood and can lead to morbidity and mortality. Foreign body aspirations should be considered time-sensitive due to the development of granulation tissue and potential accompanying complications.

Anahtar Kelimeler

Bronchoscopy , childhood , foreign body aspiration

Etik Beyan

Local ethical committee approval (AEŞH-BADEK-2024-1264) was taken from Ankara Etlik City Hospital Ethical Commitee and the study was conducted in accordance with the Helsinki Declaration of Human Rights before the study.

Destekleyen Kurum

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors

Teşekkür

None.

Kaynakça

• Na'ara S, Vainer I, Amit M, Gordin A. Foreign Body Aspiration in Infants and Older Children: A Comparative Study. Ear Nose Throat J. 2020;99(1):47-51.
• Dongol K, Neupane Y, Das Dutta H, Raj Gyawali B, Kharel B. Prevalence of Foreign Body Aspiration in Children in a Tertiary Care Hospital. JNMA J Nepal Med Assoc. 2021;59(234):111-115.
• Antón-Pacheco JL, Martín-Alelú R, López M, Morante R, Merino-Mateo L, Barrero S, et al. Foreign body aspiration in children: Treatment timing and related complications. Int J Pediatr Otorhinolaryngol. 2021; 144:110690.
• Eber E, Antón-Pacheco JL, de Blic J, Doull I, Faro A, Nenna R, et al. ERS statement: interventional bronchoscopy in children. Eur Respir J. 2017;50(6):1700901.
• Özyüksel G, Arslan UE, Boybeyi-Türer Ö, Tanyel FC, Soyer T. New scoring system to predict foreign body aspiration in children. J Pediatr Surg. 2020;55(8):1663-1666.
• Shlizerman L, Mazzawi S, Rakover Y, Ashkenazi D. Foreign body aspiration in children: the effects of delayed diagnosis. Am J Otolaryngol. 2010;31(5):320-4.
• Karakoç F, Karadağ B, Akbenlioğlu C, Ersu R, Yildizeli B, Yüksel M, et al. Foreign body aspiration: what is the outcome? Pediatr Pulmonol. 2002;34(1):30-6.
• Lin FZ, Cao W, Xu B, Liu J, Bi J, Fu Y. Risk Factors for Lower Respiratory Tract Infection Associated With Tracheobronchial Foreign Body Aspiration in Children. Ann Otol Rhinol Laryngol. 2023;132(10):1228-1232.
• Wu Y, Dai J, Wang G, Li Y, Li H, Wu C, et al. Delayed diagnosis and surgical treatment of bronchial foreign body in children. J Pediatr Surg. 2020;55(9):1860-1865.
• Kaur K, Sonkhya N, Bapna AS. Foreign bodies in the tracheobronchial tree: A prospective study of fifty cases. Indian J Otolaryngol Head Neck Surg. 2002;54(1):30-4.
• Boufersaoui A, Smati L, Benhalla KN, Boukari R, Smail S, Anik K, et al. Foreign body aspiration in children: experience from 2624 patients. Int J Pediatr Otorhinolaryngol. 2013;77(10):1683-8.
• Aydoğan LB, Tuncer U, Soylu L, Kiroğlu M, Ozsahinoglu C. Rigid bronchoscopy for the suspicion of foreign body in the airway. Int J Pediatr Otorhinolaryngol. 2006;70(5):823-8.
• Foltran F, Ballali S, Passali FM, Kern E, Morra B, Passali GC, et al. Foreign bodies in the airways: a meta-analysis of published papers. Int J Pediatr Otorhinolaryngol. 2012;76 Suppl 1:S12-9.
• Roda J, Nobre S, Pires J, Estêvão MH, Félix M. Foreign bodies in the airway: a quarter of a century's experience. Rev Port Pneumol. 2008;14(6):787-802.
• Even L, Heno N, Talmon Y, Samet E, Zonis Z, Kugelman A. Diagnostic evaluation of foreign body aspiration in children: a prospective study. J Pediatr Surg. 2005;40(7):1122-7.
• Sersar SI, Rizk WH, Bilal M, El Diasty MM, Eltantawy TA, Abdelhakam BB, et al. Inhaled foreign bodies: presentation, management and value of history and plain chest radiography in delayed presentation. Otolaryngol Head Neck Surg. 2006;134(1):92-9.
• Heyer CM, Bollmeier ME, Rossler L, Nuesslein TG, Stephan V, Bauer TT, et al. Evaluation of clinical, radiologic, and laboratory prebronchoscopy findings in children with suspected foreign body aspiration. J Pediatr Surg. 2006;41(11):1882-8.
• Sidell DR, Kim IA, Coker TR, Moreno C, Shapiro NL. Food choking hazards in children. Int J Pediatr Otorhinolaryngol. 2013;77(12):1940-6.
• Pan H, Lu Y, Shi L, Pan X, Li L, Wu Z. Similarities and differences in aspirated tracheobronchial foreign bodies in patients under the age of 3 years. Int J Pediatr Otorhinolaryngol. 2012;76(6):911-4.
• Shubha AM, Das K. Tracheobronchial foreign bodies in infants. Int J Pediatr Otorhinolaryngol. 2009;73(10):1385-9.
• Yang YH, Zhang XG, Zhang JL, Zhang YB, Kou CP. Risk factors for preoperative respiratory complications in children with tracheobronchial foreign bodies. J Int Med Res. 2016;44(2):338-45.