Tooth aspiration following emergency endotracheal intubation

Abstract

Tooth aspiration in adults during endotracheal intubation is very rare. There are several risk factors for this rare event such as old age, loose teeth, difficult intubation etc. which predispose patients for tooth aspiration in tracheobronchial tree in emergent endotracheal intubation. Although extraction of aspirated tooth with flexible bronchoscopy is a difficult and complex intervention, it is still preferred over rigid scopes due to number of advantages. This case underlines that appropriate precautions should be taken to prevent a potentially serious medico-legal complication during airway management in emergent circumstances. Also it shows how flexible broncoscope can be used effectively for extraction of foreign body without major complications.

Keywords: Emergent endotracheal intubation; Flexible bronchoscopy; Tooth aspiration.

Fig. 1

Black open arrow showing incisor tooth in apical segment of right lower lobe.

Fig. 2

Removed incisor tooth held in dormia basket with broncoscope.

Fig. 3

Dormia basket forcep.