Back
 IJOHNS  Vol.5 No.2 , March 2016
Advantage of Computed Tomography (CT) Virtual Bronchoscopy in the Evaluation of Children with Suspected Foreign Body Airway
Abstract: Background & Objectives: Foreign body aspiration (FBA) into the tracheo bronchial tree is a frequent and serious cause of respiratory distress and visit to the pediatrics emergency, principally in patients under 3 years of age. Most foreign bodies are not radio opaque and approximately one third of the children admitted will show normal chest X-ray. Virtual bronchoscopy is a relatively new and non-invasive procedure that provides a three dimensional view of the internal walls of the tracheobronchial tree through the reconstruction of axial images. The objectives of the study are, 1) to study the diagnostic accuracy and advantage of virtual bronchoscopy over rigid bronchoscopy in the evaluation of children with suspected FBA and to plan for early management as it is a non-invasive technique; 2) to study the clinical spectrum of children attending with suspected FBA. Methods: An observational study of 37 patients of age 12 yrs and below who underwent Virtual Bronchoscopy for suspected foreign body aspiration in the department of pediatrics and Otorhinolaryngology at MGM Hospital, Warangal is carried out for a period of 1.5 years during 2012-2013. Results: The common age of presentation was 1 - 3 years with male preponderance. History of foreign body was obtained in 64.86% of cases. Normal X-ray was found in 27.02% of cases. In 75.67% FB detected on rigid bronchoscopy was also revealed on virtual bronchoscopy. False positive percentage was 5.40% and false negative was 2.70%. Sensitivity and specificity was 96.5% and 75% respectively. Ground nuts were the commonest foreign bodies aspirated. Conclusion: Virtual bronchoscopy should be considered in cases with suspected foreign body aspiration, when chest X-ray is normal, to avoid needless rigid bronchoscopy. Virtual bronchoscopy is useful in screening cases of occult foreign body as it has sensitivity, specificity, and validity.
Cite this paper: Yogi, M. , Surender, K. , Jadi, L. , Chavan, S. and Prathiba, P. (2016) Advantage of Computed Tomography (CT) Virtual Bronchoscopy in the Evaluation of Children with Suspected Foreign Body Airway. International Journal of Otolaryngology and Head & Neck Surgery, 5, 59-64. doi: 10.4236/ijohns.2016.52010.
References

[1]   Kosucu, P., Ahmetoglu, A., Koramaz, I., Orhan, F., Ozdemir, O., Dinc, H., et al. (2004) Low Dose MDCT and Virtual Bronchoscopy in Pediatric Patients with Foreign Body Aspiration. American Journal of Roentgenology, 183, 1771-1777.
http://dx.doi.org/10.2214/ajr.183.6.01831771

[2]   Halilogu, M.C., Iftci, A.O., Oto, A., Gumus, B., Tanyel, F.C., Senocak, M.E., et al. (2003) CT Virtual Bronchoscopy in the Evaluation of Children with Suspected Foreign Body Aspiration. European Journal of Radiology, 48, 188-192.
http://dx.doi.org/10.1016/S0720-048X(02)00295-4

[3]   Svedstrom, E., Puhakka, H. and Kero, P. (1989) How Accurate Is Chest Radiography in the Diagnosis of Tracheobronchial Foreign Bodies in Children? Pediatric Radiology, 19, 520-522.
http://dx.doi.org/10.1007/BF02389562

[4]   Sodhi, K.S., Saxena, A.K., Singh, M., Rao, K.L. and Khandelwal, N. (2008) CT Virtual Bronchoscopy: New Non Invasive Tool in Pediatric Patients with Foreign Body Aspiration. The Indian Journal of Pediatrics, 75, 511-513.
http://dx.doi.org/10.1007/s12098-008-0080-z

[5]   Fraga Ade, M., Reis, M.C., Zambon, M.P., Toro, I.C., Ribeiro, J.D. and Baracat, E.C. (2008) Foreign Body Aspiration in Children: Clinical Aspects, Radiological Aspects and Bronchoscopic Treatment. Jornal Brasileiro de Pneumologia, 34, 74-82.

[6]   Horton, K.M., Horton, M.R. and Fishman, E.K. (2007) Pictorial Essay. Advanced Visualization of Airways with 64-MDCT:3D Mapping and Virtual Bronchoscopy. American Journal of Roentgenology, 189, 1387-1396.
http://dx.doi.org/10.2214/AJR.07.2824

[7]   Burke, A.J., Vining, D.J., Mc Guirt Jr., W.F., Postma, G. and Browne, J.D. (2000) Evaluation of Airway Obstruction Using Virtual Endoscopy. Laryngoscope, 110, 23-29.
http://dx.doi.org/10.1097/00005537-200001000-00005

[8]   Naidich, D.P. and Harkin, T.J. (1995) Airways and Lung. Correlation of CT with Fiberoptic Bronchoscopy. Radiology, 197, 1-12.

[9]   Ferretti, G.R., Vining, D.J., Knoplioch, J. and Coulomb, M. (1996) Tracheobroncheal Tree: 3D Spiral CT with Bronchoscopic Perspective. Journal of Computer Assisted Tomography, 20, 777-781.
http://dx.doi.org/10.1097/00004728-199609000-00018

[10]   McLennan, G., Shansolkottabi, S. and Hoffman, E.A. (1996) Assessment of Major Air Way Obstruction Using Image Analysis of Digital CT Information. Proceedings of SPIE, 2709, 197-208.
http://dx.doi.org/10.1117/12.237861

[11]   Atyac, A., Yurdakul, Y., Ikizler, C., Olga, R. and Saylam, A. (1977) Inhalation of Foreign Bodies in Children—A Report of 500 Cases. The Journal of Thoracic and Cardiovascular Surgery, 74, 145-151.

[12]   Bhat, K.V., Hegde, J.S., Nagalohmath, U.S. and Patil, G.C. (2010) Evaluation of Computed Tomography Virtual Bronchoscopy in Pediatric Tracheobronchial Foreign Body Aspiration. Journal of Otology and Laryngology, 124, 875-879. http://dx.doi.org/10.1017/S0022215110000769

[13]   Tandan, R.K., Pantney, N.L., Srinivastava, V.K. and Wadhawan, V.P. (1976) Foreign Body in Tracheobronchial Tree in Infancy and Childhood. The Indian Journal of Chest Diseases, 15, 214-218.

[14]   Banerjee, A., Subba Rao, K.S.V.K., Khanna, S.K., et al. (1988) Laryngo-Trachheo-Bronchial Foreign Bodies in Children. The Journal of Laryngology & Otology, 102, 1029-1032.
http://dx.doi.org/10.1017/S0022215100107170

[15]   Rothman, B.F. and Boeckmann, C.R. (1980) Foreign Bodies in the Larynx and Trachea Bronchial Tree in Children—A Review of 225 Cases. Annals of Otology, Rhinology & Laryngology, 89, 434-436.
http://dx.doi.org/10.1177/000348948008900512

[16]   Hughes, C.A., Baroody, F.M. and Bernard, R.M. (1996) Pediatric Tracheobronchial Foreign Bodies: Historical Review from the John Hopkins Hospital. Annals of Otology, Rhinology & Laryngology, 105, 555-561.
http://dx.doi.org/10.1177/000348949610500712

[17]   Steen, K.H. and Zimmerman, T. (1990) Tracheobronchial Aspiration of Foreign Bodies in Children: A Study of 94 Cases. Laryngoscope, 100, 525-530.

[18]   Bauer, T.L. and Steiner, K.V. (2007) Virtual Bronchoscopy: Clinical Applications and Limitations. Surgical Oncology Clinics, 16, 323-328.
http://dx.doi.org/10.1016/j.soc.2007.03.005

[19]   Kaur, K., Sonkhya, N. and Bapna, A.S. (2002) Foreign Bodies in the Tracheobronchial Tree: A Prospective Study of Fifty Cases. Indian Journal of Otolaryngology and Head & Neck Surgery, 54, 30-34.

[20]   Cevizci, N., Dokucu, A.I., Baskin, D. and Karadag, C.A. (2008) Virtual Bronchoscopy as a Dynamic Modality in the Diagnosis and Treatment of Suspected Foreign Body Aspiration. European Journal of Pediatric Surgery, 8, 398-401.
http://dx.doi.org/10.1055/s-2008-1038972

 
 
Top