Laryngeal foreign bodies in children: a persistent, life-threatening problem

Abstract

We reviewed the records of all patients admitted to Cardinal Glennon Children's Hospital for foreign object aspiration from 1980 to 1987. There were 11 true glottic bodies, which accounted for 12.1% of the 91 foreign bodies detected in the airways. A mortality rate of 45% (5 patients) and transient hypoxic encephalopathy in 27% (3 patients) indicate the often tragic outcome of obstruction in the pediatric larynx. Two distinct types of foreign bodies were responsible for laryngeal obstruction in these children. The first group consisted of bulky items, mostly food, and resulted in a more severe type of obstruction, with higher mortality and morbidity. The second group of objects were thin, laminar, triangular bodies, which tended to wedge unsuspectedly in the larynx, mimicking inflammatory diseases and requiring endoscopy for their removal. Hypothetical models are used to explain the physical phenomena that occur in foreign body obstruction in the two different groups. Recommendations for intervention are made based on the conclusions.