Accuracy of Virtual Bronchoscope in Diagnosis of Foreign Body Inhalation in Children

Background: Foreign body aspiration (FBA) is a prevalent and potentially life-threatening condition in pediatric populations, with a particular emphasis on children under the age of three. If not diagnosed and treated promptly, it is a primary cause of respiratory distress and is associated with substantial morbidity and mortality. Objective: The aim of this study was to detect the accuracy of virtual bronchoscope (VB) in diagnosis of foreign body inhalation in children. Patients and Methods: This retrospective study included 91 pediatric patients with a history or suspected diagnosis of foreign body aspiration and with symptoms like persistent cough, choking, or difficult breathing. All patients underwent a chest radiograph as the initial diagnostic modality, which when it was not conclusive, further evaluation was carried out using VB then rigid bronchoscopy (RB) to confirm the presence and location of the foreign body. Results: The radiograph findings (Chest X-ray) revealed that 33 patients (36.3%) had radiopaque foreign bodies while 58 patients (63.7%) had inconclusive radiographs and were subjected to further evaluation with VB. The VB findings detected 46 patients with foreign bodies, 44 of them confirmed later by RB with two false positives in VB. Virtual bronchoscope accurately identified all cases of foreign body presence with 100% sensitivity, 85.7% specificity, 95.7% positive predictive value (PPV), 100% negative predictive value (NPV), and 96.6% overall accuracy. Conclusions: VB proves to be a reliable, non-invasive diagnostic tool for detecting foreign body aspiration in children, with high sensitivity and specificity offering a safer and more accurate alternative to invasive procedures.