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The Annals of Thoracic Surgery, Vol 39, 251-253, Copyright © 1985 by The Society of Thoracic Surgeons

ARTICLES

Extraction of large tracheal foreign bodies through a tracheostoma under bronchoscopic control

EE Swensson, KH Rah, MC Kim, JW Brooks and AM Salzberg

Despite various technical manipulations through contemporary endoscopic equipment, large tracheal foreign bodies may be lost during bronchoscopic extraction, with a 1 to 2% in-hospital mortality. Recently, emergency tracheostomy was performed during bronchoscopy after a tracheal foreign body had become dislodged in the subglottic region causing blockage of the airway, and the results of this procedure provoked its deliberate application in a second patient. In 3 additional infants, aspirated tracheal T tubes (Montgomery tubes), which were producing acute respiratory distress, were brought from the carina to the performed tracheostoma under bronchoscopic manipulation and were withdrawn. Elective application of this simultaneous approach-- tracheostomy with bronchoscopy--may decrease morbidity and mortality from large tracheal foreign bodies.