ABSTRACT
The use of fiber-optic bronchoscopy [FOB] via laryngeal mask airway [LMA] in children allows the use of adult size bronchoscope with its grasping tools, thus it may aid in foreign body [FB] extraction. To evaluate the efficacy of FOB via LMA in FB extraction in pediatrics. We prospectively recruited all children [< /= 16 years] presented or referred to Pulmonary Medicine Department, Ain Shams University Hospital with clinical suspicion of FB inhalation between June 2012 and June 2013. All the patients were subjected to FOB via LMA under general anesthesia. Rigid bronchoscopy [RB] was available to extract any FB failed to be removed. Of the 49 children suspected of having FBs, 41 FBs were identified in 28 boys and 13 girls with a mean age 5.9 years [9 months to 16 years]. FBs were more often lodged in the right side than in the left one [48% vs. 38%] and with predominance of organic FBs [75.6%] mainly seeds [60.9%].Successful extraction by current technique was in 34out of 41 [82.9%] FBs identified. RB succeeded in extraction of 6 out of 7 FBs that failed to be removed and open thoracotomy was required in 1 case. Non-critical complications related to FOB via LMA included laryngeal edema, transient hypoxia, gastric distension, mild hemoptysis and fever occurred in 5, 5, 4, 3 and 2 patients respectively. One critical complication [stridor] related to RB. FOB via LMA is safe and effective in pediatric FB retrieval under general anesthesia with RB backup
ABSTRACT
A case of right aortic arch with aberrant left subclavian artery was found in a 30-year old Jordanian male, complaining of coughing and dyspnea which was unexplained. For the previous two years the patient had been treated for sinusitis and recurrent attacks of lower respiratory tract infections