STUDY THE SENSITIVITY OF COMPUTED TOMOGRAPHY IN INVESTIGATION OF ASPIRATED FOREIGN BODIES

Mayav Osso*, Mostafa Ibrahim and Youssef Youssef

ABSTRACT

Background: Foreign body aspiration (FBA) is considered a potentially life-threatening event and bronchoscopy represents the cornerstone of both diagnosis and management . Computed tomography(CT) of chest could be appropriated for diagnosis of FBA and might reduce the need for bronchoscopy. Objective: The aim of this study was to determine the diagnostic value of CT-scan in diagnosis of tracheobronchial FBA. Patients and Methods: An observational descriptive study (case series) conducted for the period one year (2022-2023) at Tishreen University Hospital in Lattakia-Syria. The study included all patients younger than 18 years who visited Otolaryngology clinic with suspected FBA and underwent to bronchoscopy. Performance of CT-scan was evaluated for some patients. Results: Out of 42 cases, 24 were male (57.1%) and 18 were female (42.9%), with mean age of the patients was 3.6±0.9 year. Age group younger than 5 years represented the most frequent group (78.6%). Wheezing (92.9%) and cough (50%) were the most frequent clinical manifestations, with presence of moderate level of FBA suspicion in 23 cases (54.8%) followed by high and low level; (40.4%) and (4.8%) respectively. Cough(p:0.02) and cyanosis(p:0.04) were detected more significantly in severe cases, as well as unilateral radiological findings were observed significantly in moderated and severe cases,p:0.0001. CT-scan was performed in 26 cases(61.9%) which was positive in 24 cases (92.3%) and negative in 2 cases (7.7%). 23 (88.5%) of the patients had a positive CT-scan and bronchoscopy resulting in a sensitivity of 100% , specificity 66.7% , positive predictive value(PPV) 95.8% , negative predictive value (NPV) 100% and accuracy 96.1%.Conclusion: The current study demonstrated that high accuracy of chest CT findings in diagnosis of FBA leads to a low rate of unnecessary bronchoscopy.

Keywords: Bronchoscopy, CT-scan, chest, foreign body aspiration, Syria.