Do residual foreign bodies in terminal bronchioles require removal?

We aimed to discuss whether residual foreign bodies in terminal bronchioles require further treatment. This retrospective study includedpatients younger than 13 years diagnosed with residual airway foreign bodies in terminal bronchioles during a 6-year-period(from May 2008 to December 2014). Parents were asked to complete questionnaires about complications caused by long-standingforeign bodies when followed-up. Thin-layer computed tomography (CT) images of the chest were analyzed before and after rigidbronchoscopy. There were 23 children (12 girls), mean age 17.17±6.35 (range 6-29) months, with residual foreign bodies incarceratedor wrapped in terminal bronchioles. The follow up after initial bronchoscopy ranged from 6 to 72 (mean 43.04±20.83) months. Fourpatients were lost during follow up. Nineteen children available for follow up experienced chronic recurrences of cough and fever,haemoptysis, chest tightness or dyspnoea after sports, or stridor and pain in the chest or back before operation. Initial chest thinlayerCT scan evaluations revealed that foreign bodies in the bronchus were frequently associated with pulmonary hyperinfl ation(14/19). Presenting symptoms and signs resolved after therapy, with statistically signifi cant improvement. On follow up, the imagesof all children were normal. In conclusion, one or two small residual foreign bodies can potentially be spontaneously eliminated orprobably coated by granulation tissue; thus, it may not be necessary to perform further invasive treatments. However, all suchchildren need long time follow up.Key words: ch ildren; foreign body aspiration; terminal bronchiole; ri gid bronchoscopy; chest thin-layer computed tomography images

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