Sentürk Ekrem, Sen Serdar
Department of Chest Surgery, Faculty of Medicine, Adnan Menderes University, Aydin, Turkey.
Tuberk Toraks. 2011;59(2):173-7.
Tracheobronchial foreign body aspiration is a health problem that can be seen in all age groups, and it requires urgent diagnosis and intervention. We report a case of an unusual foreign body aspiration in a laryngectomized patient and we aim to discuss this situation according to the literature. A 72-year-old man, who underwent total laryngectomy 7 years ago for a squamous cell carcinoma of the larynx, was reported with complaint of aspiration of a silicone tracheostomy canula. Foreign body aspiration can present with a wide variety of symptoms. Although it is sometimes asymptomatic, mostly there exists cough, dispnea, hemoptisis and even respiratory arrest. Clinical history and radiological examinations are enough for the diagnose but in some cases, it is difficult to diagnose even by bronchoscopy. In this report, ethiology, pathogenesis, clinical presentation, diagnose and treatment of foreign body aspirations are discussed under the light of the literature. Ethiology and pathogenesis are beneficial for the assessment of treatment time and method. Appropriate and ontime clinical intervention makes the diagnosis to be easier. Treatment timing and methods are important to prevent the complications. Flexible bronchoscopy can be used for the diagnose and is preferential to remove small and fit foreign bodies. For children, for complicated cases and in order to remove penetrating or amorph-shaped bodies rigit bronchoscopy should be preferred.
气管支气管异物吸入是一个可见于所有年龄组的健康问题，需要紧急诊断和干预。我们报告一例喉切除术后患者发生的罕见异物吸入病例，并旨在根据文献对这种情况进行讨论。一名72岁男性，7年前因喉鳞状细胞癌接受了全喉切除术，现因硅酮气管切开套管吸入前来就诊。异物吸入可表现出各种各样的症状。虽然有时无症状，但大多数情况下存在咳嗽、呼吸困难、咯血甚至呼吸骤停。临床病史和影像学检查足以进行诊断，但在某些情况下，即使通过支气管镜检查也难以诊断。在本报告中，根据文献讨论了异物吸入的病因、发病机制、临床表现、诊断和治疗。病因和发病机制有助于评估治疗时间和方法。适当且及时的临床干预会使诊断更容易。治疗时机和方法对于预防并发症很重要。可弯曲支气管镜可用于诊断，并且更适合取出小而合适的异物。对于儿童、复杂病例以及为了取出穿透性或无定形物体，应首选硬质支气管镜。
