Doctors Discover Missing Dentures Lodged in Patient Larynx After Surgery

A 72-year-old patient arrived at a hospital emergency department coughing up blood, experiencing severe difficulty swallowing, and requiring supplemental oxygen, following a surgical procedure where his metal denture became lodged in his larynx. The man had undergone surgery under general anesthesia eight days prior for the removal of a benign tumor on his abdominal wall when the dental prosthesis was displaced and inhaled into his respiratory tract.

Initial Misdiagnosis and Emergency Return

During his first visit to the emergency department, a physical examination of the throat, a chest X-ray, and blood tests revealed no major anomalies, leading physicians to diagnose a lower respiratory tract infection. The patient was discharged with a prescription for antibiotics, corticosteroids, and a mouthwash. He returned to the emergency department two days later because his symptoms persisted, including ongoing blood-spitting, an inability to swallow medication, and newly developed breathing difficulties.

Discovery of the Denture in the Larynx

Subsequent X-rays led doctors to suspect aspiration pneumonia, prompting a referral to an ear, nose, and throat department for further evaluation. While examinations of the pharynx and lymph nodes showed no issues, an otolaryngologist inserted a thin, flexible tube through the nose to explore the respiratory tract and discovered a metal plate covering the patient’s vocal cords. The object was identified as the patient’s missing denture, composed of a metal plate and three incisors, which he acknowledged losing during his general surgery eight days earlier.

Surgical Extraction and Medical Complications

Medical personnel successfully extracted the denture using a pair of forceps. However, the patient’s health did not improve immediately, requiring ongoing treatment for pneumonia and four separate hospitalizations due to continued blood-spitting. The hemorrhaging proved severe enough to require two additional surgical interventions and blood transfusions.

Hospital Protocols and Safety Recommendations

Treating physicians at James Paget University Hospital in Great Yarmouth emphasized the need for heightened vigilance regarding removable dental prostheses during surgical interventions. Dr. Harriet Cunniffe, co-author of the published case report in BMJ Case Reports, stated that the presence of any dental appliance must be clearly documented before and after procedures, and all operating room staff must understand perioperative protocols for removable devices. Dr. Cunniffe also noted that initial emergency staff missed an opportunity by failing to investigate the patient’s swallowing difficulties more thoroughly during his first visit.

In France, the removal of removable dental prostheses is mandatory before entering an operating room, alongside the removal of jewelry, piercings, eyewear, and nail polish. The French Society of Anesthesia and Reanimation highlights that failure to remove dentures prior to general anesthesia and tracheal intubation risks dislodgement, breakage, swallowing, or displacement into the respiratory tract, which can cause severe obstruction or asphyxiation.