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 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.