To explore the clinical characteristics of tracheobronchial foreign bodies in different age groups and the experience of electronic bronchoscopy in diagnosis and treatment.

The data of 234 patients with tracheobronchial foreign bodies diagnosed in the Respiratory Endoscope Center of West China Hospital of Sichuan University from December 2012 to November 2019 were collected, and the demographic, clinical characteristics and endoscopic diagnosis and treatment related data were analyzed retrospectively.

A total of 234 effective cases were included, including 39 cases of <14 years old group, 126 cases of 14-64 years old group and 69 cases of ≥65 years old group.There were more males than females in all three groups.The history of misinhalation accounted for 76.9% in <14 years old group, while only 32.5% and 33.3% in 14-64 years old group and ≥65 years old group.There was statistical difference among the three groups ( χ²=26.31, P<0.001). The patients with a medical history of less than seven days accounted for 64.1% of the patients under 14 years old, but those of the patients aged 14-64 and ≥ 65 years old accounted for only 19.0% and 21.7%, respectively.There was a statistical difference among the three groups (χ²=31.98, P<0.001). In terms of clinical symptoms, cough and sputum were the main symptoms in the 14-64 years old group and ≥65 years old group, while 71.8% of the patients in the <14 years old group had no obvious symptoms, and there were statistical differences among the three groups in terms of whether they had symptoms or not (χ²=30.37, P<0.001). Food was the most common type of foreign body, including pepper/capsicum, bones and organic matter.Plastics and teeth (dentures) were also important sources in the <14 years old group and ≥65 years old group.The success rate of extraction of foreign bodies under bronchoscope was 97.4%, and 66.2% of the foreign bodies were removed by local anesthesia.The right lower lobe bronchus was the most common site of foreign bodies in the ≥14 years old group, while the most common site of foreign bodies in the <14 years old group was the right middle segmental bronchi.Granulation hyperplasia was a common microscopic manifestation.Most foreign bodies were removed with a single auxiliary tool and only 21.5% used two or more assistive tools.

The occurrence of foreign body is related to gender and age, and people of different ages are easy to be misdiagnosed because of no clear history of misinhalation or obvious symptoms.The most common foreign body is the lower lobe of the right lung, and granulation tissue hyperplasia is the most common microscopic manifestation, and the incidence increases with the increase of the course of the disease.Most foreign bodies can be removed with single tools such as rat tooth forceps, biopsy forceps or alligator forceps.Bronchoscopy is the most direct and effective method for the diagnosis and treatment of trachea and bronchial foreign bodies.

Foreign body; Trachea, bronchus; Electronic bronchoscopy