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Emerg Med J 30:85 doi:10.1136/emermed-2012-201325
  • Images in emergency medicine

Speech prosthesis aspiration

  1. Rodolfo C Morice
  1. The University of Texas MD Anderson Cancer Center, Department of Pulmonary Medicine, Unit 1462, Houston, Texas, USA
  1. Correspondence to Dr Rodolfo C Morice, Department of Pulmonary Medicine, Unit 1462, The University of Texas MD Anderson Cancer Center, 1515 Holcombe, Houston, TX 77030, USA; rcmorice{at}mdanderson.org
  1. Contributors HG collected data and wrote the manuscript. RRM and FJE contributed by writing and revising the manuscript. CAJ contributed by reviewing the radiographic images and writing the manuscript.

  • Accepted 15 March 2012
  • Published Online First 15 April 2012

A 68-year-old woman with a history of laryngeal cancer status post-laryngectomy was referred to the emergency room for an abnormal chest CT scan. The scan showed a small dense object in the distal aspect of the left mainstem bronchus at the orifice of the left lower lobe and left upper lobe bronchus consistent with an aspirated foreign body (figure 1). Upon our evaluation, the patient denied having cough, haemoptysis, shortness of breath or any history of aspiration episodes.

Figure 1

CT scan showing foreign body in the patient.

The patient underwent bronchoscopy, which revealed a foreign object embedded in the mucosa at the carina of the left upper lobe and left lower lobe bronchus. We removed the object and were surprised to discover that it was a speech prosthesis (figure 2).

Figure 2

(A) Bronchoscopic image of the foreign body. (B) Speech prosthesis after bronchoscopic removal.

Only a few cases of prosthetic appliances aspiration in patients with permanent post-laryngectomy tracheal stoma were reported.1 We believe that the presence of such a stoma should be added to the risk factors for foreign body aspiration. In patients with tracheostomies, recollection of the aspiration event may be absent and symptoms may appear only after complications develop. Physicians should be aware of the risks of foreign body aspiration in patients with tracheostomies.

Footnotes

  • Competing interests None.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; internally peer reviewed.

Reference


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