Man developed pneumonia after metal denture lodged in larynx, report says
A 72-year-old patient returned to the emergency department spitting blood, experiencing difficulty swallowing, and requiring oxygen, after medical staff discovered a metal denture lodged in his larynx, futura-sciences.com reported. The patient had undergone general anesthesia eight days prior for the removal of a benign abdominal wall tumor at an unspecified hospital.
Key Clinical Takeaways:
- A 72-year-old man was admitted to the emergency room with hemoptysis, dysphagia, and respiratory distress caused by an inhaled denture.
- The prosthesis had remained stuck in his larynx for eight days following a prior general surgery procedure.
- Treating physicians had initially diagnosed a lower respiratory tract infection before specialized ENT examination revealed the foreign body.
Patient Returns After Initial Misdiagnosis of Respiratory Infection
During the patient’s first presentation to the emergency department, throat examination, chest radiography, and blood tests showed no severe abnormalities. Medical personnel diagnosed a lower respiratory infection and discharged the septuagenarian with antibiotics, corticosteroids, and a mouthwash. Two days later, the patient returned with persistent bleeding, inability to swallow medications, and oxygen dependence.
Additional radiographs led physicians to suspect pneumonia triggered by substance inhalation. An ear, nose, and throat (ENT) specialist performed a flexible nasal endoscopy after finding no abnormalities in the pharynx or lymph nodes. The scope identified a metal plate covering the patient’s vocal cords. The patient subsequently stated he lost his denture—consisting of a metal base and three incisors—during general surgery eight days earlier.
Denture Extraction Leads to Pneumonia and Severe Bleeding
Physicians successfully extracted the denture using forceps. However, the patient’s condition did not immediately stabilize. He required ongoing treatment for pneumonia and four separate hospital admissions due to recurrent bleeding. The hemorrhage was severe enough to necessitate two additional surgical procedures and blood transfusions.
According to Dr. Harriet Cunniffe, co-author of the case report published by James Paget University Hospital in Great Yarmouth, medical teams must exercise strict oversight regarding removable dental prostheses. Dr. Cunniffe noted that healthcare providers during the initial emergency visit did not adequately investigate the patient’s swallowing difficulties. A lateral neck radiograph subsequently confirmed the position of the denture in the throat.
Clinicians Must Document and Monitor Removable Dental Prostheses
The case report emphasizes that clinicians must verify whether patients wear dentures and monitor their placement during procedures. Dr. Cunniffe stated that the presence of any dental prosthesis should be clearly documented before and after interventions, and all operating room personnel must understand perioperative protocols for removable dental work.
In France, removing removable dental prostheses is mandatory prior to entering the operating room, alongside the removal of jewelry, piercings, glasses, and nail polish. The French Society of Anesthesia and Resuscitation (SFAR) highlights the risks associated with muscle relaxation and tracheal intubation during general anesthesia, noting that unremoved dentures can become dislodged, fractured, swallowed, or displaced into the respiratory tract, causing severe obstruction or asphyxiation.
While denture ingestion or inhalation remains rare, a 15-year study published in 2016 documented 91 distinct incidents across 28 countries.
Disclaimer: The information provided in this article is for educational and scientific communication purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider regarding any medical condition, diagnosis, or treatment plan.