The case is of an 8 year old school boy who had accidentally aspirated a handreamer during dental treatment. Before extraction he had been seen by an Otolaryngologist and a Bronchoesophagologist. The foreign body was then extracted through the bronchoscope.
Dr. Nishimura and I discussed several matters concerning extraction of foreign bodies located in the pharyngo-laryngeal area, esophagus and tracheo-bronchial tree, among which were:
1. The technic of local anesthesia of the pharyngo-laryngeal area, when a foreign body is located there.
2. The importance of radiological examination for differential diagnosis of the type and location of the foreign body in the broncho-esophagological area.
3. Attempt at removal of the foreign body by Endoscopy (Esophagoscopy and Bronchoscopy) without Tracheotomy or open chest procedure.
4. The lesion produced in the bronchial mucus membrane where the foreign body was lodged, will require several months for recovery, therefore, observation by bacteriological and radiological examination should be done periodically while observing the patient's general condition.
5. The exsistence of fungus in bronchial specimens determined bacteriologically, in this and similar cases without radiologicol and subjective changes, may suggest contaminatian from dental caries.
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