BEAD IN TRACHEOBRONCHIAL TREE: A THERAPEUTIC CHALLENGE

Objective: To find out management strategy of bead as a foreign body in tracheobronchial tree.Material and Methods: We managed thirty children having bead in tracheobronchial tree. As most of them were in respiratory distress, they were treated on emergency basis. On bronchoscopy, due to rounded and slippery nature of the bead, the extraction is not possible with ordinary forceps. But due to a small hole inside the bead, we were able to pass a minute forceps into this hole and upon opening the prongs of this forceps, beads were extracted. In case of failure, tracheostomy was done or help of cardiothoracic surgeon for thoracotomy was sought.Results: Our study consists of thirty children having bead in tracheobronchial tree. Males were 18 (60%) and females were 12(40%). Fifteen (50%) patients were in between 6-8 years. Twenty five (83.3%) children came within 24hours after bead inhalation. In about 18(60%) cases foreign body was lying in trachea. Beads were removed through bronchoscopy in 25 (83.3%) cases, while 3(10%) beads were removed through tracheostomy and 2(6.6%) beads were openly removed through thoracotomy. Mortality was nil while morbidity was found in 5(16.6%) cases.Conclusion: Foreign body in tracheobronchial tree can be managed easily with the present bronchoscopic technique and special extraction instruments but bead is still a challenging foreign body and at times need further surgical options like tracheostomy or thoracotomy.