Abstract
Respiratory failure occurs due to various causes in patients with severe motor and intellectual disabilities (SMID). Our patient developed dyspnea and expiratory wheezing at night. Treatment for bronchial asthma temporarily improved his condition, however it worsened again and led to respiratory failure. A foreign body on the left main bronchus was suspected on chest radiography, and an attempt was made to remove it with a bronchoscope under general anesthesia, but the foreign body was incarcerated and difficult to remove. A few days later, it was confirmed that the foreign body had moved into the right main bronchus by physiotherapy. After retrying with the bronchoscope, the foreign body with a size of 2.5-cm was removed and was identified as tartar containing calcium phosphate. After removing the foreign body, his symptoms were improved. In our patient, difficulty in opening his mouth by muscle hypertonia may have led to insufficient daily oral hygiene, resulting in the formation of tartar. Thereafter, deciduous tartar was aspirated and became a foreign body in the airway, and consequently, the patient experienced respiratory failure. This case suggests the importance of oral hygiene in patients with SMID.
