J Dent Anesth Pain Med.  2019 Apr;19(2):119-123. 10.17245/jdapm.2019.19.2.119.

Foreign body aspiration during dental treatment under general anesthesia: A case report

• Doh RM

• KMID: 2444757
• DOI: http://doi.org/10.17245/jdapm.2019.19.2.119

Abstract

Foreign body aspiration in dental clinics is the most common cause of respiratory emergencies. There are no reports on foreign body aspiration during dental treatment under stable general anesthesia because the patient neither has voluntary movements nor reflex actions. This is a case report on the fall of a prosthesis in the larynx, which occurs rarely under general anesthesia. During the try-in procedure, the prosthesis slid from the surgeon's hand and entered the retromylohyoid space, and while searching for it, it passed down the larynx to the endotracheal tube balloon, leading to a dangerous situation. The prosthesis was promptly removed using video-assisted laryngoscope and forceps, and the patient was discharged without any complications.

Keyword

Aspiration; Foreign bodies; General Anesthesia

MeSH Terms

Anesthesia, General*
Dental Clinics
Emergencies
Foreign Bodies*
Hand
Humans
Laryngoscopes
Larynx
Prostheses and Implants
Reflex
Surgical Instruments

Figure

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  Fig. 1 A posteroanterior (PA) chest and dental radiographs of the patient. (A) Chest PA obtained before surgery showed normal findings. (B–E) Panoramic view and intraoral radiographs of the patient at first operation day.

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  Fig. 2 (A) Video laryngoscopy with touch screen (AceScope, Acemedical Co., Seoul, Korea) and curvilinear forceps. (B) The gold crown of tooth 36 found inside the neck.

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  Fig. 3 Intraoral photographs of patients with oropharyngeal pack. (A) The patient of this case report. The arrows indicate the gap between the oropharyngeal pack and the tongue. (B) Another patient in a similar situation. The tongue and an oropharyngeal pack are completely closed between the mouth and the pharynx.

Reference

1. Park WS, Kim ST, Park MS, Seo JS, Kim KD. Foreign Body Asporation in Dental clinic - Case Series. J Korean Dent Soc Anesthesiol. 2011; 11:38–44.

2. Hou R, Zhou H, Hu K, Ding Y, Yang X, Xu G, et al. Thorough documentation of the accidental aspiration and ingestion of foreign objects during dental procedure is necessary: review and analysis of 617 cases. Head Face Med. 2016; 12:23.

3. Kim KN, Kim KS, Lee HJ, Oh YN. Accidental ingestion of a fixed partial denture during general anesthesia - A case report. Anesth Pain Med. 2015; 10:138–140.

4. Fields RT Jr, Schow SR. Aspiration and ingestion of foreign bodies in oral and maxillofacial surgery: a review of the literature and report of five cases. J Oral Maxillofac Surg. 1998; 56:1091–1098.

5. Pingarron Martin L, Moran Soto MJ, Sanchez Burgos R, Burgueno Garcia M. Bronchial impaction of an implant screwdriver after accidental aspiration: report of a case and revision of the literature. Oral Maxillofac Surg. 2010; 14:43–47.

6. Hidaka H, Suzuki T, Toyama H, Kurosawa S, Nomura K, Katori Y. Dislocated dental bridge covering the larynx: usefulness of tracheal tube guides under video-assisted laryngoscopy for induction of general anesthesia, thus avoiding tracheostomy. Head Face Med. 2014; 10:23.

7. Davis J, Anaes FC, Alton H, Butler J. Aspiration of foreign materials in children while under general anesthesia for dental extractions. Anesth Pain Control Dent. 1993; 2:17–21.