Correlation between Virtual Bronchoscopy with Intraoperative Rigid Bronchoscopy Findings in Tracheobronchial Foreign Bodies

Abstract

Background: Foreign body aspiration is a persistent paediatric emergency, particularly in developing countries, and contributes substantially to illness and death. Removal of tracheobronchial foreign bodies is usually achieved through rigid bronchoscopy, a procedure associated with a mortality rate of up to 1.8%. This study aimed to evaluate the diagnostic accuracy of computed tomography-based virtual bronchoscopy (VB) by comparing its findings with those of rigid bronchoscopy (RB). The study also examined the utility of VB in children both with and without a clear history of aspiration.

Methods: Children presenting with either a suggestive history of aspiration or symptoms of airway obstruction underwent virtual bronchoscopy followed by intraoperative rigid bronchoscopy, after written informed consent was obtained.

Results: Thirty-six children underwent both VB and RB. VB identified a foreign body in 33 patients; RB confirmed the finding in 31 cases, while two were later diagnosed with mucus plugs. In three patients where VB showed no foreign body, RB revealed two plastic pen caps and one mucus plug. Overall, VB demonstrated a sensitivity of 93.94% (79.77–99.26%), a positive predictive value of 93.94% (87.39–97.20%), and an accuracy of 88.89% (73.94–96.89%).

Conclusion: Virtual bronchoscopy offers high sensitivity and positive predictive value in evaluating suspected tracheobronchial foreign bodies. Although not a substitute for RB, it is a valuable complementary tool that can guide management and reduce unnecessary invasive procedures.