Bronchoscopic extraction of aspirated foreign bodies in children.

New instruments and techniques have refined the art of extracting aspirated foreign bodies from children. During a five-year period at the University of New Mexico, Albuquerque, bronchoscopic extractions were successful in 40 of 41 children (98%). The extractions were performed with the patient under general anesthesia, using a pediatric ventilating bronchoscope that contained the Hopkins rod-lens system. Two methods of extraction were used, depending on the shape of the foreign object: the Fogarty balloon technique for spherical objects, and the forceps technique for flat objects. Using these techniques, most foreign bodies (80%) were removed on the first or second pass of the bronchoscope. Because bronchoscopic extraction is a delicate procedure and carries a risk of cardiorespiratory arrest, it should be performed by endoscopists and anesthesiologists who are skilled with this procedure in children.