Basic human airway anatomy. Objects can enter the trachea and lungs via the mouth or nose. Signs and symptoms of<unk>  vary based on the site of obstruction, the size of the<unk> <unk> , and the severity of obstruction. 20% of<unk>  bodies become lodged in the upper airway, while 80% become lodged in a bronchus. Signs of<unk>  are usually abrupt in onset and can involve coughing, choking, and/or wheezing; however, symptoms can be slower in onset if the<unk> <unk>  does not cause a large degree of obstruction of the airway. With this said, aspiration can also be asymptomatic on rare occasions. Classically, patients present with acute onset of choking. In these cases, the obstruction is classified as a partial or complete obstruction. Signs of partial obstruction include choking with drooling, stridor, and the patient maintains the ability to speak. Signs of complete obstruction include choking with inability to speak or absence of bilateral breath sounds among other signs of respiratory distress such as cyanosis. A fever may be present. When this is the case, it is possible the object may be chemically irritating or contaminated.<unk>  bodies above the larynx often present with stridor, while objects below the larynx present with wheezing.<unk>  bodies above the vocal cords often present with difficulty and pain with swallowing and excessive drooling.<unk>  bodies below the vocal cords often present with pain and difficulty with speaking and breathing. Increased respiratory rate may be the only sign of<unk>  in a child who cannot verbalize or report if they have swallowed a<unk> <unk> . If the<unk> <unk>  does not cause a large degree of obstruction, patients may present with chronic cough, asymmetrical breath sounds on exam, or recurrent pneumonia of a specific lung lobe. If the aspiration occurred weeks or even months ago, the object may lead to an obstructive pneumonia or even a lung abscess. Therefore, it is important to consider chronic<unk>  in patients whose histories include unexplained recurrent pneumonia or lung abscess with or without fever. In adults, the right lower lobe of the lung is the most common site of recurrent pneumonia in<unk> . This is due to the fact that the anatomy of the right main bronchus is wider and steeper than that of the left main bronchus, allowing objects to enter more easily than the left side. Unlike adults, there is only a slight propensity towards objects lodging in the right bronchus in children. This is likely due to the bilateral bronchial angles being symmetric until about 15 years of age when the aortic knob fully develops and displaces the left main bronchus. Signs and symptoms of<unk>  in adults may also mimic other lung disorders such as asthma, COPD, and lung cancer. {
Foreign body aspiration
Pulmonary aspiration
Tracheoinnominate fistula
Intubation granuloma
Tracheal tumor
Exercise-induced laryngeal obstruction
Laryngopharyngeal reflux
Bronchopleural fistula