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March 1987

Laryngotracheal Foreign Bodies in Children: A Comparison With Bronchial Foreign Bodies

Author Affiliations

From the Department of Otolaryngology, University of Washington, Seattle.

Am J Dis Child. 1987;141(3):259-262. doi:10.1001/archpedi.1987.04460030037019

• Twenty cases of laryngotracheal foreign bodies were reviewed over an 11-year period to determine features that differentiate these from bronchial foreign bodies. A history of choking or aspiration was obtained in 18 patients (90%). The most common presenting symptoms were stridor, wheezing, sternal retractions, and cough. The chest roentgenogram was most often normal (58% [11/19]). Posteroanterior and lateral neck roentgenograms suggested the diagnosis in 92% (12/13) of the patients. The correct diagnosis was made within the first 24 hours of presentation in 11 patients (55%); 19 patients (95%) were correctly diagnosed within one week. The incidence of major complications was 45% (9/20); however, in patients with a delay in diagnosis of over 24 hours the complication rate was 67% (6/9). For this reason, in children with a diagnosis of croup or reactive airway disease who respond poorly or whose condition deteriorates despite appropriate medical therapy, early endoscopy should be considered.

(AJDC 1987;141:259-262)

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