Abstract
Aspiration of foreign bodies into the airway is a life-threatening emergency, in which the major issues involve the accurate diagnosis and immediate retrieval of the foreign bodies. In general, a foreign body in the tracheobronchial tree is more common in children than in adults. However, foreign-body aspiration in adults happens in various situations which contribute to the aspiration. This paper presents two adult cases of aspirated foreign bodies and discusses the debilitating factors that will predispose adults to foreign-body aspiration.
Case 1 is a 70-year-old man with ALS, who repeatedly aspirated foods or his false teeth. The patient exhibits premature spillage from the mouth to the hypopharynx before swallowing and oropharyngeal residue after swallowing. Case 2 is a 70-year-old man with tracheostomized due to bilateral laryngeal paralysis. He demonstrated a foreign body (bread crust) in the trachea, and it was removed with a basket forceps through a fiberscopic bronchoscope.
The definitive treatment in tracheobronchial foreign-body aspiration is removal as soon as possible. It is universally agreed that a ventilation bronchoscope under general anesthesia is the instrument of choice in extracting foreign bodies. However, a fiberscopic bronchoscope may be a valuable therapeutic option for specific adult cases. On the other hand, a swallowing examination in adults may show premature spillage and pharyngeal delay, and these findings relate to the accidental aspiration of foreign bodies into the airway. To prevent the aspiration of foreign bodies in adults, it is important to treat swallowing performance.
