The Utility of Endoscope-Assisted Rigid Bronchoscopy in Pediatric Airway Foreign Body Removals Introduction: Aspiration of foreign bodies is an emergency condition in children and may result in death, especially in children under 3 years of age. Therefore, diagnosis and treatment must be made rapidly. Objective: This study sought to summarize our experience with endoscope-assisted rigid bronchoscopy (RB) in the diagnosis and treatment of pediatric tracheobronchial foreign body emergencies to reduce complications and mortality. Methods: This was a retrospective cross-sectional study. The medical records of 337 children diagnosed with clinically suspected airway foreign body aspiration in the pediatric emergency department were analyzed retrospectively. The patients were divided into 2 groups with endoscopy used during RB in group 1 whereas group 2 was RB only. The surgeons who performed the bronchoscopies completed a survey on the advantages/disadvantages of these 2 procedures. Results: All of the patients had a positive history of suspected foreign body aspiration and foreign bodies were identified in 77.1% of the patients during RB. There were 161 (47.8%) patients in group 1 and 176 (52.2%) patients in group 2. In group 2, 5 patients showed transient hypoxia, and 6 patients had an episode of transient bleeding during the operations. These numbers were 3 and 3, respectively, in group 1. One patient in group 2 suffered cardiac arrest and died during surgery. The authors did not see any long-term complications after these operations and the authors did not find any statistically significant differences between the groups for complication rates. Conclusion: The RB is the gold standard procedure for removal of pediatric airway foreign bodies. The survey used in this study and our extensive experience have shown that the distal bronchi and foreign bodies can be visualized more effectively when using a rigid endoscope during RB, especially in children under the age of 3 years. In order to improve the safety of the surgical procedure, the authors propose that endoscope-assisted RB should be used in emergencies concerning foreign bodies in the airways of children. Address correspondence and reprint requests to Suleyman Ozdemir, MD, Cukurova University School of Medicine, Department of Otorhinolaryngology Head & Neck Surgery, 01380, Adana/Turkey; E-mail: drsozdemir@gmail.com Received 16 March, 2019 Accepted 30 April, 2019 The authors report no conflicts of interest. Suleyman Ozdemir: ORCID ID: https://orcid.org/0000-0002-0125-1536 Ozgur Surmelioglu: ORCID ID: https://orcid.org/0000-0001-5041-2802 Ozgur Tarkan: ORCID ID: https://orcid.org/0000-0002-0689-6632 Ulku Tuncer: ORCID ID: https://orcid.org/0000-0002-0689-1751 Mete Kiroglu: ORCID ID: https://orcid.org/0000-0001-5711-9182 Muhammed Dagkiran: ORCID ID: https://orcid.org/0000-0002-1923-3731 Supplemental digital contents are available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.jcraniofacialsurgery.com). © 2019 by Mutaz B. Habal, MD.