1. Trachea diseases and esophagus diseases The Otolaryngology Faculty of Shanghai Jiao Tong University School of Medicine Xiang Mingliang

2. Anatomy of trachea and bronchus

3. Trachea: in the middle of neck and thoracic cavity. 16-20 trachea rings in total, and 7- 8 ring in the neck.

4. Bronchus tree. The angle between the trachea and the bronchus: left45 o, right25 o

5. carina of trachea: the end of trachea. A important mark in the bronchoscopy

6. Anatomy of esophagus

7. Muscular organ. Pipe in shape Inner layer: mucosa Middle layer: submucosal tissue external layer: muscle

8. Physiological stenosis in esophagus 1 ） from upper incisor 16cm 2 ） from upper incisor 23cm 3 ） from upper incisor 27cm 4 ） from upper incisor 36cm

9. foreign body in trachea and bronchus Source ： external 、 internal Classification of foreign body ： plant ： peanut 、 seeds. animal ： fishbone 、 bone pieces mineral ： iron nail synthetic product ： dental prosthesis

10. 90% cases ﹤ 5 years, 80% cases ﹤ 3 years causes ： 1 ） poorly chew function, poorly pharyngeal reflex 2 ） unconscious ， aspiration ３） unhealthy habit: foreign body in mouth 4 ） medical:

11. Factors associated with clinic presentation foreign body sorts ： peanut ， chemical bronchitis Size: Shape: Stay time: Stay site Infection or not:

12. presentation –Inhaled period ： cough ， dyspnea –Quiet period ： no any symptom –Infection period ： cough ， dyspnea, fever –Complication period ： atelectasis 、 emphysema 、 lung infection

13. diagnosis ： history of foreign body ， dyspnea 、 cough ， disorder sign in X-ray X-ray ： 1 ） obstructive emphysema 2 ） obstructive atelectasis ＣＴ scan ： three-dimensional rebuild treatment ： bronchoscopy

17. Foreign body in bronchus

18. Foreign body in trachea

20. Foreign body in bronchus

21. Foreign body in esophagus cause More cases in old: poorly chew function, disesthesia of mouth, dental prosthesis More cases in children ： like to put toy in his mouth Eating too quick Stenosis or lump in esophagus suicide

22. Sorts of foreign body animal ： fishbone,bone pieces, meat lump metals ： coin synthetic product ： dental prosthesis plant ： kernel

23. Location of foreign body The first stenosis: most seen The second stenosis The third stenosis

24. Clinic symptoms dysphagia odynophagia dyspnea ： large foreign body

25. X-ray examination nonopaque ： positive in barium x-ray study opaque ： x-ray flat. entopic and lateral examination of esophagus

26. complication Esophagus perforation Infection of periesophagus organ ： neck,mediastinum Large artery disruption Tracheal-esophageal fistula

27. diagnosis ： history of foreign body ， d ysphagia,odynophagia ， disorder sign in X- ray treatment ： esophagoscopy Electronic gastroscopy open ： foreign body in out of esophagus, injury of large artery

28. Foreign body in esophagus

30. Thanks