The Journal of Laryngology & Otology

Main Articles

Evaluation of computed tomography virtual bronchoscopy in paediatric tracheobronchial foreign body aspiration

K V Bhata1 c1, J S Hegdea1, U S Nagalotimatha1 and G C Patila2

a1 Department of Otolaryngology, Head and Neck Surgery, Karnataka Institute of Medical Sciences, Hubli, Karnataka, India

a2 Department of Radiodiagnosis, Karnataka Institute of Medical Sciences, Hubli, Karnataka, India

Abstract

Objective: Virtual bronchoscopy is a noninvasive technique which provides an intraluminal view of the tracheobronchial tree. This study aimed to evaluate this technique in comparison with rigid bronchoscopy, in paediatric patients with tracheobronchial foreign bodies undetected by plain chest radiography.

Methods: Plain chest radiography was initially performed in 40 children with suspected foreign body aspiration. Computed tomography virtual bronchoscopy was performed in the 20 in whom chest radiography appeared normal. Virtual bronchoscopic images were obtained. All patients underwent rigid bronchoscopy performed by an otolaryngologist blinded to the computed tomography virtual bronchoscopy findings, within 24 hours. Virtual bronchoscopic findings were then compared with the results of rigid bronchoscopy.

Results: In 12 patients, foreign bodies detected by virtual bronchoscopy were confirmed by rigid bronchoscopy. In one case, a mucous plug was perceived as a foreign body on virtual bronchoscopy. In another case, a minute foreign body was missed on virtual bronchoscopy. The following parameters were calculated: sensitivity, 92.3 per cent; specificity, 85.7 per cent; validity, 90 per cent; positive likelihood ratio, 6.45; and negative likelihood ratio, 0.089.

Conclusion: In the presence of a positive clinical diagnosis and negative chest radiography, computed tomography virtual bronchoscopy must be considered in all cases of tracheobronchial foreign body aspiration, in order to avoid needless rigid bronchoscopy. Computed tomography virtual bronchoscopy is particularly useful in screening cases of occult foreign body aspiration, as it has high sensitivity, specificity and validity.

(Accepted January 18 2010)

(Online publication April 29 2010)

Correspondence:

c1 Address for correspondence: Dr K Vikram Bhat, 102 Arvind Apartments, Kalyan-nagar, Hubli 580031, Karnataka, India. E-mail: vikram.ent@gmail.com

Footnotes

Dr K V Bhat takes responsibility for the integrity of the content of the paper.

Competing interests: None declared

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