The most frequent indication requiring the interventions with rigid bronchoscopes in pediatrics is the aspiration of foreign bodies. The aspiration of foreign tracheobronchial bodies is a problem which is found primarily in childhood.
In 90 per cent of the cases children below the age of 15 are concerned, and 80 per cent of the children are below 4 years of age. Boys are affected twice as frequently as girls. There are several reasons for this accumulation within the first years of life. Children do not have a sufficient number of teeth to be able to chew food properly. A lack of co-ordination of the swallowing mechanism leads to frequent choking, thus causing the danger of aspiration. Moreover, there is a desire and continuous curiosity to explore everything that is in the vicinity. A lot of these items are put in the mouth whereby the child is not yet able to differentiate between potentially hazardous things and food. Another danger is the proximity to the ground where a lot of small things can be found.
The primary symptoms may differ considerably. On the one hand, a prolonged bout of coughing may be suspicious, and on the other hand cyanosis (bluish discoloration of the skin due to a lack of oxygen), apnoea (respiratory standstill) and even cardiac arrest may occur. In the US, about 2,000 deaths
occur per year as a consequence of aspiration.
The lethality caused by the aspiration of a foreign body is stated at about 1 per cent in general. Primarily children are concerned, in which a critical displacement of the respiratory tract occurs immediately after the aspiration which renders an adequate treatment impossible or the first-aider is not sufficiently trained for the event. Most frequently sausages, hard sweets, nuts and grapes are the causes of fatal aspiration.
Rigid bronchoscopes are used to remove foreign bodies as well as to examine the deeper passages of the respiratory tract.

The opening laterally arranged at the distal end ensures that bronchi on the opposite side of the inspiratory gas flow are reached during the examination of the bronchial system. Thus, the bronchoscope need not be pulled back proximally into the trachea in phases of ventilation, which minimises the time needed as well as the risk of traumatisation caused by the repeated change of position of the bronchoscope.
When extracting foreign bodies from the peripheral bronchial sections, for example, it is important that the bronchoscope is perfectly located in front of the foreign body and need not be repositioned for each working step (as in case of the display with the telescope, suction, insertion of the forceps, et cetera), thus risking a dislocation of the foreign body.

The newly developed ultra-thin “semi-flexible” mini fibre endoscope d = 2 mm (82512.431) with its outstanding resolution has proved itself in bronchoscopy for children, in cases of emergency in particular it is a helpful supplement to the conventional instruments, This endoscope can be used to visualise and pass through passages of critical stenoses even (non touching in most cases even). The flexible construction permits easy work at small filigree diameters and reduces the risk of a rupture several times.
On account of its insensitivity to bending load, the endoscope is highly suitable for the optically controlled extraction of foreign bodies. For this purpose, the bronchoscope forceps are introduced first, and then the endoscope is passed into the bronchoscope tube; the endoscope and the bronchoscope forceps can be manipulated independently of each other. This technique is recommended for difficult extractions of foreign bodies in particular.