This documents give a broad insight on various Aerodigestive forign bodies that can get into the Nose and Throat with appropriate medical management.

1. AERODIGESTIVE FOREIGN
BODIES

2. Outline
● Introduction
● Definition
● Types of foreign bodies
● Clinical presentation
● Diagnostic tools
● Management
● Complications
● Prevention strategies
● Conclusion

4. INTRODUCTION
Foreign Body In Aerodigestive tract is a common clinical occurrence
• It is an ENT Emergency
• Foreign Body enters the body by either
- Ingestion: 'F.B. Esophagus"
- Aspiration: "F.B. Bronchus*

5. DEFINITION
Aerodigestive foreign bodies refer to objects or substances that accidentally enter
and get stuck in the airway or the digestive tract.

6. EPIDEMIOLOGY
- Children >>> Adults
- Boys > Girls
- No Racial / Geographical Predisposition

7. Types of foreign bodies
Foreign bodies can be classified as either inorganic or organic.
● Inorganic materials are typically plastic or metal, such as beads or toys.
These materials are often asymptomatic and may be discovered incidentally.
● Organic foreign bodies may include food, rubber, wood, and sponges and
tend to be more irritating to the nasal mucosa; thus, they may produce earlier
symptoms. Peas, beans, and nuts are among the more common organic
NFBs

8. Types of foreign bodies
Animate and inanimate
● Animate FB: Maggot, worms, cockroach, beetle, ants,
● Inanimate FB: vegetable FB such as peas & beans, Mineral FB such as
metal plastic and toys, Eraser

9. Clinical Presentation
Signs and symptoms include
● Coughing
● Choking
● Wheezing
● Difficulty breathing
Early recognition is vital!

10. Investigations
X-ray Neck and Chest
- Always get both AP and Lateral views
- Radiopaque foreign bodies easily seen
- Radiolucent foreign bodies evidenced by Air in the oesophagus
Barium Swallow
- Radiolucent foreign body well visualized
Esophagoscopy

11. Radio-opaque foreign body

12. Double Lumen Sign: Disc Battery

13. Radiolucent foreign body in the oesophagus

14. Management of Aerodigestive Foreign Bodies
Management of ingestion or aspiration of foreign bodies usually depend on:
● Type of the object
● Location of the object
● Clinical status of patient
Prior to treatment, detailed history should be taken with proper physical examination
done, to determine these.
Management for foreign bodies in the aerodigestive tract may be:
● Expectant management
● Emergent management
● Definitive management

15. Management of Aerodigestive Foreign Bodies
Expectant Management
This management technique involves watchful waiting.
Expectant management is appropriate particularly for patients with ingestion since
most objects will pass uneventfully.
It is only decided on, after a proper assessment of the patient and may be employed:
● Following recent ingestion of foreign body
● Following blunt object ingestion
● While awaiting spontaneous expulsion in stool
● In preparation for definitive removal

16. Management of Aerodigestive Foreign Bodies
Emergency Management
These should be applied if there is complete airway obstruction.
Patients with complete airway obstruction require immediate medical attention
and typically are aphonic and unable to breathe.
Patients who are coughing, gagging, and vocalizing have partial obstruction.
Ingestion of caustic foreign bodies like button batteries should also be considered
as an emergency as delay in these patients may lead to esophageal perforation.

17. Management of Aerodigestive Foreign Bodies
First aid maneuvers in the emergency management of aerodigestive foreign
bodies include:
● Finger sweep/grasp
● Heimlich maneuver
● Chest thrusts
● Back blows
Emergency procedures may also be indicated such as:
● Emergency bronchoscopy if patient is in severe respiratory distress
● Emergency esophagoscopy for battery ingestion

18. Management of Aerodigestive Foreign Bodies

19. Management of Aerodigestive Foreign Bodies
Definitive Management
Endoscopic Removal
Endoscopic procedures are useful for visualizing and diagnosing foreign bodies as
well as image-guided removal. They include:
● Pharyngoscopy
● Bronchoscopy
○ Rigid bronchoscopy
○ Flexible fiber optic bronchoscopy
● Oesophagoscopy
○ Rigid oesophagoscopy
○ Flexible esophagoscopy

20. Management of Aerodigestive Foreign Bodies

21. Management of Aerodigestive Foreign Bodies
Definitive Treatment
Surgical Management
Almost all foreign bodies can be extracted endoscopically. If endoscopy is unsuccessful, surgical removal
may be necessary.
Surgical management of aerodigestive foreign bodies may be planned or emergency. They include
methods such as:
● Laryngotomy(Cricothyroidotomy) / Emergency tracheostomy
● Tracheostomy
● Oesophagostomy
○ Cervical Oesophagostomy
○ Transthoracic Oesophagotomy
● Laparotomy in case of bowel perforation

22. Management of Aerodigestive Foreign Bodies
Supportive Treatment
● Bronchodilators
● Humidified oxygen
● Antibiotics in cases of organic or animate foreign bodies
● Steroids
● Chest physiotherapy
● Patients should always be reassessed for residual airway obstruction

23. Complications of Aerodigestive Foreign Bodies
● Aspiration Pneumonia
● Airway obstruction
● Esophageal perforation
● Gastrointestinal obstruction
● Mucosal injury
● Infection
● Chronic respiratory symptoms
● Psychological impact
● Complications from removal procedures

24. PREVENTION STRATEGIES
This involves a combination of education, environmental modifications, and safety
measures. They include:
1. Educating parents and caregivers about the risks of certain foods, toys, and
household items.
2. Encouraging proper chewing and sitting while eating to reduce the risk of
choking.
3. Supervising children during mealtime and play to prevent ingestion of small
objects.
4. Storing small objects out of reach of children

25. PREVENTION STRATEGIES
5. Keep small objects, household chemicals, and medications stored in secure
cabinets or drawers.
6. Childproof the home by installing safety gates, securing heavy furniture and
appliances, and using outlet covers.
7. Providing age-appropriate toys and avoiding toys with small detachable parts
for young children
8. Provide caregivers with basic first aid training.Ensure that caregivers know how
to recognize the signs of airway obstruction and when to seek emergency medical
assistance.

26. CONCLUSION
In conclusion, Preventing aerodigestive foreign bodies is essential for public
health, as they can result in serious consequences such as choking and
respiratory distress.
Empowering individuals, caregivers, and communities through awareness and first
aid training enables proactive prevention and is essential for establishing safer
environments