The proximal bronchoplasty retrieval technique for removal of embedded distal airway foreign bodies

Objectives: To describe a novel technique for removal of embedded distal airway foreign bodies with emphasis on procedural steps and management. Methods: The proximal bronchoplasty retrieval (PBR) technique is described including indications, rationale, surgical technique, and clinical decision making. Two representative cases are described in detail in order to demonstrate the technique. Results: The PBR technique was successfully used to remove the two described embedded distal airway foreign bodies after other attempts had failed. Conclusion: Airway foreign bodies which have been present for several days or weeks are associated with edema and granulation tissue which often embeds the foreign body and may prevent removal dueto proximal airway narrowing. We present a novel technique using endoscopic balloon dilation bronchoplasty to enlarge the airway proximal to the foreign body and enable removal with two example cases presented herein. The PBR technique allowed for removal of otherwise stuck distal airway foreign bodies.