Foreign Bodies in the Airway: Endoscopic Methods

Airway foreign body (FB) retrieval is synonymous with the birth of interventional pulmonology and bronchology. Once known to be a condition associated with significant morbidity and mortality, the advent of rigid bronchoscopy and other advanced bronchoscopic techniques has drastically improved outcomes related to FB aspiration. Patients that present with acute FB aspiration (hours/days after event) usually present with minimal signs of airway inflammation, while patients with retained FBs tend to have many associated complications such as severe airway inflammation, granulation tissue, bronchial stenosis, and/or post-obstructive pneumonia. The decision to use rigid and/or flexible bronchoscopy should be guided by the patient’s clinical presentation, FB features, and presence of inflammatory sequelae. The interventional pulmonologist has a multitude of techniques and instruments at his/her disposal to successfully manage the retrieval of FBs. Adequate knowledge and training combined with the ability to treat potential adverse events is required to ensure patient safety and to obtain the best outcome.