Tracheobronchial foreign body aspiration in laryngectomized patient with tracheoesophageal voice prosthesis

A patient with a total laryngectomy and tracheoesophageal voice prosthesis presented with tracheobronchial aspiration of a Phillips-head screw that was swallowed inadvertently and aspirated around a loose-fitting prosthesis. A modified esophagram showed a screw in the right lung and free leakage of...

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Bibliographic Details
Published in:Clinical imaging 2018-05, Vol.49, p.181-183
Main Authors: Chorney, Michael A., Dubin, Randy M., Levine, Marc S.
Format: Article
Language:English
Subjects:
Barium
Bronchi
Bronchus
Dysphagia
Esophagus
Fistula
Foreign Bodies
Humans
Laryngeal cancer
Laryngectomy - adverse effects
Larynx
Larynx, Artificial - adverse effects
Lung
Lungs
Male
Middle Aged
Ostomy
Patients
Pneumonia
Pneumonia, Aspiration
Prostheses
Prosthesis Failure - adverse effects
Radiographs
Radiography
Respiratory Aspiration - etiology
Respiratory System - pathology
Surgery
Thoracic surgery
Total laryngectomy
Trachea
Tracheobronchial foreign body aspiration
Tracheoesophageal voice prosthesis
Voice prostheses
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Summary:A patient with a total laryngectomy and tracheoesophageal voice prosthesis presented with tracheobronchial aspiration of a Phillips-head screw that was swallowed inadvertently and aspirated around a loose-fitting prosthesis. A modified esophagram showed a screw in the right lung and free leakage of barium from the cervical esophagus around the prosthesis into the tracheobronchial tree. Chest radiographs and CT confirmed a screw in a right lower lobe bronchus with postobstructive pneumonia. When this complication occurs, it is important to extract the foreign body and, if necessary, to adjust or remove the prosthesis to prevent future aspiration pneumonias or foreign body aspiration. •Patient with loose-fitting TEP after laryngectomy aspirated screw around prosthesis.•Patient developed postobstructive pneumonitis distal to screw in right lower lobe bronchus.•Esophagram showed screw in right lung and leakage of barium around TEP into airway.•Important to adjust or remove TEP to prevent future foreign body aspiration or aspiration pneumonia.
ISSN:0899-7071
1873-4499
DOI:10.1016/j.clinimag.2018.03.012