When bronchoscopy does not suffice for airway foreign body removal: a series of cases requiring tracheotomy.

PURPOSE: To illustrate the importance of tracheotomy in difficult cases of foreign body inhalation and to enumerate the indications of the same. METHODS: A retrospective analysis of 5 cases in which the standard rigid bronchoscopic approach had to be combined with the open surgical approach (tracheotomy) for the removal of the inhaled foreign body for different indications. RESULTS: Combining the two procedures lead to successful removal of foreign body and restoration of airway in all the cases. Tracheostomies whenever performed were temporary. CONCLUSIONS: Foreign body aspiration is an otorhinolaryngologic emergency that can rapidly prove fatal if not well-handled. Though most cases can be dealt with by traditional approaches, a proportion of the cases may prove challenging and need a quick tailoring of response according to the situation at hand. An approach combining tracheotomy with the traditional bronchoscopic approach is one such way and in well-selected cases, can have a significant impact on the outcome; sometimes even in terms of life and death.