Laryngeal foreign bodies in children revisited

To review our experience with inhaled laryngeal foreign bodies in children, we performed a retrospective review of all admissions to our institution between March 1989 and March 2002 with the diagnosis of an inhaled laryngeal foreign body. We included only cases in which the diagnosis was confirmed at endoscopy under general anesthesia. Two children were dead on arrival at our institution as a result of upper airway obstruction following a choking episode and did not undergo endoscopy; they were not included. Nine children (5 male, 4 female) were identified. The age range was 5 months to 13 years 9 months, although only 1 child was older than 32 months. The foreign body was removed within 24 hours of a witnessed choking episode in 4 children, and the diagnosis was delayed in 5 children for a period between 4 days and 2 months, including 2 in whom a history of a choking episode had been initially obtained. One complication occurred in a child in whom the diagnosis was delayed; he developed laryngeal edema after foreign body removal and required endotracheal intubation for 1 week.