CT Scan in Children Suspected of Foreign Body Aspiration: A Systematic Review and Meta-analysis.

Autor: El Khoury P; Department of Otolaryngology-Head and Neck Surgery, Hotel Dieu de France Hospital, Saint Joseph University, Beirut, Lebanon., Makhoul M; Department of Otolaryngology-Head and Neck Surgery, Hotel Dieu de France Hospital, Saint Joseph University, Beirut, Lebanon., El Hadi C; Department of Otolaryngology-Head and Neck Surgery, Hotel Dieu de France Hospital, Saint Joseph University, Beirut, Lebanon., Haber C; Department of Radiology, Hotel Dieu de France Hospital, Saint Joseph University, Beirut, Lebanon., Rassi S; Department of Otolaryngology-Head and Neck Surgery, Hotel Dieu de France Hospital, Saint Joseph University, Beirut, Lebanon.
Jazyk: angličtina
Zdroj: Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery [Otolaryngol Head Neck Surg] 2024 Jan; Vol. 170 (1), pp. 1-12. Date of Electronic Publication: 2023 Jul 20.
DOI: 10.1002/ohn.433
Abstrakt: Objective: The goal of this study is to evaluate the sensitivity and specificity of computed tomography (CT) scans in the diagnosis of foreign body aspiration (FBA) in children, and to determine whether chest CT scans would reduce the need for diagnostic rigid bronchoscopies.
Data Sources: MEDLINE, EMBASE, Scopus, and the Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched for relevant articles and conference proceedings that were published in English through November 1, 2022.
Review Methods: We included prospective and retrospective studies comparing chest CT scans and rigid bronchoscopy for the diagnosis of FBA in pediatric patients (<16 years old). The pooled estimates of the sensitivity and specificity of the chest CT scan in the diagnosis of FBA were calculated using a fixed- or common-effects analysis and a random-effects analysis that accounts for heterogeneity if present. Forest plots were constructed to combine the evidence identified during the systematic review.
Results: Eighteen articles (4178 patients) were included. The average age of the children was 2.26 (±0.75) years, and 65% (±5.64%) of them were boys. Cough was the most prevalent symptom upon presentation. The pooled analysis showed that the sensitivity of chest CT scan in detecting a foreign body in children was 99% (95% confidence interval, CI [97, 100]; I 2  = 72%, τ 2  = 0.0065, p < .01). The false negative rate was 1.8% (95% CI [0.3, 2.7]; I 2  = 72%, p < .01). The specificity of chest CT scan was 92% (95% CI [83, 98]; I 2  = 83%, τ 2  = 0.0437, p < .01).
Conclusions: Chest CT scan is a sensitive and specific test for the diagnosis of FBA in the pediatric population. Its use can help to reduce unnecessary rigid bronchoscopies, especially in patients with a low clinical suspicion of aspiration. It should not be a replacement for the gold standard bronchoscopy, particularly in cases where there is a clear history and symptoms suggestive of aspiration.
(© 2023 American Academy of Otolaryngology-Head and Neck Surgery Foundation.)
Databáze: MEDLINE
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