A 9-year-old male patient consulted at our department because of severe dysphagia, cervical contracture, excessive weight loss, and hot-potato voice that had started six months previously after orotracheal intubation due to an elective orthopedic foot surgery.
The patient had a normal oral examination and therefore, a lateral neck X-ray was requested in order to rule out subglottic stenosis or any other laryngeal lesion. An uncommon foreign body was found: A wrong-size Guedel cannula was lodged in the hypopharynx, placed at the esophagus entry protruding through the upper third of the tracheal pars membranacea into the airway lumen.
The extraction was performed with a Miller laryngoscope and Magill forceps without any complications. The video shows the laryngoscopy prior to the extraction see in below video, Supplemental Digital Content 1).
Supplemental Digital Content 1
Lateral neck X-rays should be part of the initial evaluation if laryngeal injury is suspected after intubation. They reveal not only normal or pathologic airway parameters as shown in image, but can also demonstratea radiopaque foreign body as labeled .
Voice alterations and dysphagia are well-known postoperative complications after orotracheal intubation. Most of them are thought to be related to airway manipulation and are expected to resolve after a short period of time . Persistent or worsening symptoms outside the immediate postoperative window warrant additional work-up and expansion of the differential diagnosis to include airway foreign bodies [2,3]. This can be done by performing an ordinary lateral neck X-ray and/or a fibrolaryngoscopy.
Dysphagia and voice disorders after a surgical procedure due to a medical foreign body.
Support was provided solely from institutional and departmental sources.
The authors declare no competing interests.