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Chest x-ray lateral view showing the fragment of the tracheostomy tube and signs of chronic obstructive lung disease.
Source publication
Aspiration of a broken tracheostomy tube fragment is a relatively rare complication with the potential to result in serious airway complications. Case reports of tracheal fragment aspiration have been documented infrequently in the past, with the earliest documented case in 1960. What follows is a case report of an 80-year-old male patient whose tr...
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Background
Removal of a tracheostomy tube in critically ill neurologic patients is a critical issue during intensive care treatment, particularly due to severe dysphagia and insufficient airway protection. The “Standardized Endoscopic Evaluation for Tracheostomy Decannulation in Critically Ill Neurologic Patients” (SESETD) is an objective measure o...
Introduction
Foreign body aspiration is usually a serious condition that is most common among the pediatric population, and rare in adults. In adults, aspiration may be tolerated for a long time.
Case Reports
Our first case is a 38-year-old man who presented with a 2-day history of swallowing a foreign body. He was completely asymptomatic. Chest X...
Citations
... In two other reports, TT fracture commonly occurred at the junction between the tracheostomy neck plate and the TT and at the site of the TT fenestration. [18][19][20] The location of bronchial foreign bodies depends on the age of the patient. Above 15 years of age, foreign bodies more commonly lodge in the right main bronchus because it is wider, shorter, and more vertical than the left especially if the patient was in an erect position at the time of inhalation. ...
Background
Tracheostomy is an important life-saving surgical procedure that could be used to secure the lower airway. It can however serve as a source of airway compromise when fragments from it are deposited. This condition must be diagnosed early enough, and appropriate intervention should be done to forestall potential morbidity and mortality.
Case Report
A 56-year-old tracheostomized patient presented to the accident and emergency department with a 4-hour history of sudden onset choking cough and labored breathing. The shaft of his tracheostomy tube (TT) was fractured and subsequently aspirated while he was attempting to remove and clean the inner tube that morning. He has used the TT for about 6 years and lost to follow-up clinic visits. The chest radiograph showed the metallic foreign body lodged within the trachea. He had an emergency rigid bronchoscopy via the tracheostomy stoma, and the object was retrieved. All respiratory symptoms subsequently resolved, and a check radiograph showed normal findings.
Conclusion
Tracheostomy tube fracture and aspiration should be ruled out in every tracheostomized patient with sudden onset acute respiratory symptoms. Otolaryngologists must always emphasize the need for proper handling of TT, regular follow-up, and tube replacement when due.
... Thus, we conclude differences exist in the manufacturing process employed. It has been reported in the literature that oxidation of copper during melting and/or casting can result in a poor surface finish, which may be the case regarding this study's findings [39][40][41][42][43]. ...
... Cheung and Napolitano 6 described a technique for removal of a tracheostomy fragment in which the best method was direct vision using a bronchoscope and administration of general anesthesia; in another case, conscious sedation was used. 7 In the present case, the metal fragment was found in the left trachea, which is rare. It was removed using a laryngoscope through the tracheostomy stoma. ...
Objective:
This study was performed to investigate the management of general anesthesia in an unusual case involving a patient with a broken tracheostomy tube presenting as an airway foreign body.
Methods:
We herein describe the anesthetic management of a patient with a broken tracheostomy tube. A 77-year-old Chinese man who had been involved in a car accident underwent a tracheostomy. One year later, he presented with cough and bleeding at the tracheostomy site. Preoperative evaluation revealed that the metal tracheostomy tube was lodged in his left main bronchus. General anesthesia was induced to maintain spontaneous breathing, and adequate topical anesthesia of the airway was administered.
Results:
The metal tracheostomy tube was successful removed, and a new tracheal tube was put in place.
Conclusions:
General anesthesia to maintain spontaneous breathing and adequate topical anesthesia of the airway can be safely used when removing broken tracheostomy tubes.
