Diagnostic Evaluation Of Foreign Body Aspiration In Children

INTRODUCTION: The aim of this study was to evaluate the place of clinical symptoms and findings, and radiological imaging in the diagnosis of foreign body aspiration in children, and to investigate the validity of existing diagnostic algorithms.
METHODS: Medical records of 120 children who underwent rigid bronchoscopy with the diagnosis of FBA were examined. The sensitivity and specificity of the parameters used in the diagnosis of FBA and their predictive values were calculated.
RESULTS: 78.9% of the patients were younger than 3 years and 63.8% were male. The peak incidence was 18 months. The rate of negative bronchoscopy was 30.8% and 87.3% of these patients were younger than 3 years. It was observed that the value with the highest diagnostical sensitivity and diagnostic accuracy rate (sensitivity; 92.54% and diagnostic accuracy; 85.7%) had positivity of the any of the radiological findings, and among these, there was detection of one-sided excessive ventilation on chest X-ray (sensitivity; 70.0% and diagnostic accuracy; 70.01%) Patients with positivity of any of the radiological findings who additionally had wheezing together with cyanosis or dyspnea had 100% specificity.
DISCUSSION AND CONCLUSION: Particularly, male children under age of 3 years have an increased risk of FBA. Neither clinical symptoms nor radiological findings alone are sufficiently specific and sensitive in the diagnosis of FBA. The most important factor in the decision to perform bronchoscopy is the evaluation of radiological findings together with physical examination and history.