Aero-digestive foreign

bodies in ENT
Dr Amina Seguya
Otolaryngologist
Foreign bodies in the nose
• Common among children under
3 years

Presentation
• Asymptomatic
• Discovered accidentally by parent
• Unilateral nasal discharge
• Occasionally bloody
Management
• Removal can be with
• Forceps –paper, cotton, sponge
• Blunt hook
• Round objects

Complications
• Nasal infection
• Rhinolinth
• Inhalation to the airway
Foreign bodies in the oesophagus
• Common in children and Presentation
mentally impaired adults • Drooling
• Common objects • Dysphagia
• Coins
• Bones
• Discomfort
• Bones • Neck pain
• Toys
• Disc batteries
• Large pieces of food
Investigation: Lateral and AP X ray
X ray
Management
• Esophagoscopy to visualise and
remove the foreign body
Airway foreign bodies
Airway foreign bodies
• Common in young children
• 80% younger than 3 years
• 4th leading cause of death in
young children
• Males more than females
• Inhalation may be accidental
(children) or deliberate (mentally
compromised)
Why increased risk in younger
children?
• Oral exploration phase
• Absent molars
• Poorly coordinated swallow
reflex
Clinical features
Symptoms On Examination
• Severe respiratory distress • Fever
• Cough • Pneumonitis, pneumonia

• Stridor • Reduced oxygen saturations

• Severe distress
• Choking signs
• Lung crepitations
• Drooling
• Asymmetric air entry
• Wheezing • Right more than left due to more
vertical orientation of right
bronchus
Diagnosis
• Made clinically • Foreign body in trachea
• Rigid bronchoscopy
• Both diagnostic and therapeutic

Normal foreign body

Only stable patients should have imaging like x ray or CT scan
done!!!

Lung collapse Foreign body in left main bronchus

Complications
• Lung collapse
• Bronchial injury
• Lung abscess
• Pneumothorax
• Empyema
• Airway stenosis
• Hypoxic brain injury
• Death
Tracheostomy
• Surgical airway through an
anterior neck skin incision the
trachea to bypass the upper
airways
Indications
• upper airway obstruction
• E.g. laryngeal tumours, laryngeal
foreign bodies
• Prolonged intubation
• assist with pulmonary toilet
• Via suction
• protection from aspiration
Tracheostomy
Complications
• Intraoperative: • Long-term Complications:
• Bleeding • tracheal stenosis
• Pneumothorax • granulation tissue formation
• Pneumo-mediastinum • subglottic stenosis

• Immediate Postoperative:
• Pulmonary edema
• acute obstruction (mucous plug)
• loss of airway (tracheotomy tube
not secured)
 Assignment
How do you take care of a patient with a
tracheostomy tube?