Skip Navigation
Skip to contents

KMJ : Kosin Medical Journal

OPEN ACCESS
SEARCH
Search

Articles

Page Path
HOME > Kosin Med J > Volume 29(1); 2014 > Article
Original Article
Efficacy of Foreign Body Removal using a Cryoprobe in Flexible Bronchoscopy
Go Eun Yeo, Sung-Jin Nam, Yu Jin Han, Eun Jeong Kim, Nam Kyu Kim, So Young Ock, Weon Hyoung Lee, Chul Ho Oak, Mann Hong Jung, Tae Won Jang
Kosin Medical Journal 2014;29(1):31-36.
DOI: https://doi.org/10.7180/kmj.2014.29.1.31
Published online: December 17, 2014

Department of Internal Medicine, College of Medicine, Kosin University, Busan, Korea

Corresponding Author: Chul Ho Oak, Department of Internal Medicine, College of Medicine, Kosin University, 34 Amnamdong, Seo-gu, Busan, 602-702, Korea TEL: +82-51-990-6104 FAX: +82-82-51-990-3049 E-mail: oaks70@daum.net
• Received: June 18, 2013   • Revised: August 27, 2013   • Accepted: October 16, 2013

Copyright © 2014 Kosin University School of Medicine Proceedings

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

  • 896 Views
  • 5 Download
  • Objectives
    Endobronchial foreign body impaction is a medical emergency because of the air way obstruction. Therefore, immediate foreign body removal is crucial in such situations. Recently, there have been several reports about cryoprobe use as a tool for removal of foreign bodies. In this study, we determined the efficacy and complications of foreign body removal using a cryoprobe during flexible bronchoscopy.
  • Methods
    This is a retrospective review of 27 patients who visited Kosin University Gospel Hospital from August 2007 to August 2010 with respiratory symptoms due to a foreign body in the airway. There were 17 males and 10 females, aged from 7 to 78 years. The foreign bodies were more frequently located (55%) in the right bronchus. The cryoprobe was inserted through the forceps channel of the flexible bronchoscope under local anesthesia. The lesion was quickly frozen for 5 seconds at -80℃, and the bronchoscope was removed with the probe after crystal formation on the contacted area.
  • Results
    The success rate of removal of foreign bodies was 85% (23/27) using the cryoprobe. One case of broncholith did not undergo attempted removal because of the possibility of excessive hemorrhage by the tight bronchus impaction, and three cases (plastic, silicon, and implant) failed due to limited crystal formation. There were no severe hemorrhages, arrhythmias, or casualties during the procedure.
  • Conclusions
    The removal of foreign body using a cryoprobe during flexible bronchoscopy was shown to be safe and effective. The nature of the material should be attempted before removing a foreign body.
Fig. 1.
The system for cryoprobe removal, a) cryosurgical unit b) flexible cryoprobe and c)pedal of the cryosurgical unit.
kmj-29-31f1.jpg
Fig. 2.
a) Broncholith was removed by cryotherapy through flexible bronchoscopy. b) The length of a removed stone at the right middle bronchus was 1.3 cm. (Reference: A Case of Endobronchial Actinomycosis with Broncholith Removed by Cryotherapy through Flexible Bronchoscopy. Scheduled to be published in Kosin Medical Journal, December of 2013).
kmj-29-31f2.jpg
Fig. 3.
a) A fish bone was extracted from the bronchus. b) Size of the extracted fishbone compared with a human finger tip. c) An impacted artificial tooth crown was seen on bronchoscopy. d) The artificial tooth crown was successfully extracted.
kmj-29-31f3.jpg
Table 1.
Patient demographics and accompanying symptoms
Variable
Age/Mean age (years) 7~78/39  
Male/Female 17/10 63/37(%)
Symptoms Number of patient Percentage (%)
Coughing 27 100
Sputum 25 92
Dyspnea 17 63
Wheezing 10 37
Chest pain 10 37
Fever 10 37
Table 2.
Location of impacted foreign bodies
Bronchus location Number of cases Percentage (%)
Right main bronchus 15 55
Left main bronchus 5 19
Right middle bronchus 5 19
Left lingular bronchus 2 7
Table 3.
Types of foreign bodies
Type Number of foreign bodies
Broncholith 10
Peanut 5
Fishbone 4
Chicken bone 1
Tooth 2
Artificial tooth 2
Plastic 1
Implant 1
Silicon tube 1
Table 4.
Removal method and number of foreign bodies
Type Number of cases
Cryotherapy 23
Snare removal 1 (screw)
Forgarty catheter 2 (bead, silicon tube)
Surgical treatment 1 (broncholith)
(e.g., lobectomy)  
  • 1. Son CY, Wee JO, Kim SO, Oh IJ, Park CM, Kim KS, et al. A Retrospective Review of Tracheobronchial Foreign Bodies. Tuberc Respir Dis 2005;58:600–6.Article
  • 2. Lee JH, Ahn JH, Shin AY, Kim SJ, Kim SJ, Cho GM, et al. A Promising Treatment for Broncholith Removal Using Cryotherapy during Flexible Bronchosopy: Two Case Reports. Tuberc Respir Dis 2012;73:282–7.Article
  • 3. al-Majed SA, Ashour M, al-Mobeireek AF, al-Hajjaj MS, Alzeer AH, al-Kattan K. Overlooked inhaled foreign bodies: late sequelae and the likelihood of recovery. Respir Med 1997;91:293–6.ArticlePubMed
  • 4. Rafanan AL, Mehta AC. Adult airway foreign body removal. What's new? Clin Chest Med 2001;22:319–30.ArticlePubMed
  • 5. Ramirez-Figueroa JL, Gochicoa-Rangel LG, Ramirez-San Juan DH, Vargas MH. Foreign body removal by flexible fiberoptic bronchoscopy in infants and children. Pediatr Pulmonol 2005;40:392–7.ArticlePubMed
  • 6. Lamaze R, Tréchot P, Martinet Y. Bronchial necrosis and granuloma induced by the aspiration of a tablet of ferrous sulphate. Eur Respir J 1994;7:1710–1.ArticlePubMed
  • 7. Debeljak A, Sorli J, Music E, Keceli P. Bronchoscopic removal of foreign bodies in adults: experience with 62 patients from 1974-1998. Eur Respir J 1999;14:792–5.ArticlePubMed
  • 8. Burton EM, Brick WG, Hall JD, Riqqs W Jr, Houston CS. Tracheobronchial foreign body aspiration in children. South Med J 1996;89:195–8.ArticlePubMed
  • 9. Shivakumar AM, Naik AS, Prashanth KB, Shetty KD, Praveen DS. Tracheobronchial foreign bodies. Indian J Pediatr 2003;70:793–7.ArticlePubMed
  • 10. Ramírez-Figueroa JL, Gochicoa-Rangel LG, Ramírez-San Juan DH, Vargas MH. Foreign body removal by flexible fiberoptic bronchoscopy in infants and children. Pediatr Pulmonol 2005;40:392–7.ArticlePubMed
  • 11. Lyu J, Song JW, Hong SB, Oh YM, Shim TS, Lim CM, et al. Bronchoscopic Cryotherapy in Patients with Central Airway Obstruction. Tuberc Respir Dis 2010;68:6–9.Article
  • 12. Hsu WC, Sheen TS, Lin CD, et al. Clinical experiences of removing foreign bodies in the airway and esophagus with a rigid endoscope: a series of 3217 cases from 1970 to 1996. Otolaryngol Head Neck Surg 2000;122:450–4.ArticlePubMed
  • 13. Cohen SR, Herbert WI, Lewis GB Jr, Geller KA. Foreign bodies in the airway: five-year retrospective study with special reference to management. Ann Otol Rhinol Laryngol 1980;89:437–42.ArticlePubMed
  • 14. Oguzkaya F, Akcali Y, Kahraman C, Bilgin M, Sahin A. Tracheobronchial foreign body aspirations in childhood: a 10-year experience. Eur J Cardiothoracic Surg 1998;14:388–92.Article
  • 15. Gorenstein A, Neel HB, Sanderson DR. Transbronchoscopic cryosurgery of respiratory structures: experimental and clinical studies. Ann Otol Rhinol Laryngol 1976;85:670–8.ArticlePubMed
  • 16. Limper AH, Prakash UB. Tracheobronchial foreign bodies in adults. Ann Intern Med 1990;112:604–9.ArticlePubMed
  • 17. Kim YH, Choi CW, Choi HS, Park MJ, Kang MH, Yoo JH. Clinical Features of Tracheobronchial Foreign Bodies in Adults according to the Risk of Aspiration. Tuberc Respir Dis 2008;64:356–61.Article
  • 18. Baharloo F, Veyckemans F, Francis C, Biettlot MP, Rodenstein DO. Tracheobronchial foreign bodies: presentation and management in children and adults. Chest 1999;115:1357–62.ArticlePubMed

Figure & Data

References

    Citations

    Citations to this article as recorded by  

      • PubReader PubReader
      • Cite
        CITE
        export Copy
        Close
      • Download Citation
        Download Citation
        Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.

        Format:
        • RIS — For EndNote, ProCite, RefWorks, and most other reference management software
        • BibTeX — For JabRef, BibDesk, and other BibTeX-specific software
        Include:
        • Citation for the content below
        Efficacy of Foreign Body Removal using a Cryoprobe in Flexible Bronchoscopy
        Kosin Med J. 2014;29(1):31-36.   Published online December 17, 2014
        Close
      • XML DownloadXML Download
      Figure

      KMJ : Kosin Medical Journal