Tracheo-oesophageal speech using a one-way speaking valve is a common mode of speech rehabilitation for laryngectomy patients. Aspiration of this device can cause significant airway obstruction and pose anaesthetic and surgical challenges during its retrieval. In this case report, we describe our management of a patient who had had a laryngectomy who aspirated his speaking valve through his stoma. Emergency retrieval of the valve was performed, during which difficulties were encountered, first in obtaining an adequate seal for pre-oxygenation, and second in maintaining adequate oxygen saturation. We discuss some innovative techniques that could be used to address these issues.
National Cancer Statistics Clearing House, Australian Institute of Health and Welfare2007. June; Cat. no. CAN 32; pp. 144.
2.
RehurekL.Unusual complications caused by a foreign body in the tracheobronchial tree.Laryngoscope1975; 85: 1767–1769.
3.
CannonC.R.Small tracheal stoma: an unusual cause of aspiration.South Med J1982; 75: 512–513.
4.
FinkelsteinD.M., NoyekA.M., FriedbergJ., GoldbergM.Inhalation of a safety pin by a laryngectomized patient: a case report.J Otolaryngol1989; 18: 189–192.
5.
EliasharR., SichelJ Y., DanoI., SaahD.Foreign body aspiration in a laryngectomized patient.Am J Emerg Med1998; 16: 103–104.
6.
ErdozainR.I., SanchezG.L., ZabaletaL.M., Sanchez del HoyoA.[Tracheobronchial foreign body in the laryngectomized patient].An Otorrinolaringol Ibero Am1998; 25: 185–192.
7.
NwilohJ., FortsonJ.Aspirated foreign body in a laryngectomized patient: case report and literature review.Ear Nose Throat J2001; 80: 744–746, 748.
8.
SanI., AlatasN., IynenI.[An unusual tracheobronchial aspiration in a patient with total laryngectomy].Kulak Burun Bogaz Ihtis Derg2002; 9: 139–141.
9.
MormileM., BalzanoB., ManiscalcoM., IepparelliG., SanduzziA., LeoneC.A.Recurrent foreign body aspiration in the airways in a laryngectomized patient.Otolaryngol Head Neck Surg2003; 129: 152–153.
10.
UzaslanE., UrsavasA., EdigerD., KaradagM.An unusual way of tracheal stoma cleaning could end up with foreign body aspiration in a laryngectomized patient.Tuberk Toraks2005; 53: 61–64.
11.
LooC.M., HsuA.A., EngP., OngY.Y.Case series of bronchoscopic removal of tracheobronchial foreign body in six adults.Ann Acad Med Singapore1998; 27: 849–853.
12.
LimperA.H., PrakashU.B.Tracheobronchial foreign bodies in adults.Ann Intern Med1990; 112: 604–609.
13.
HathurusingheH., UppalH., ShortridgeR., ReadC.Case of the month: dislodged tracheo-oesophageal valve: importance of rapid replacement or stenting.Emerg Med J2006; 23: 322–324.
14.
BhallaR.K., CorriganA., RolandN.J.Comparison of two face masks used to deliver early ventilation to laryngectomized patients.Ear Nose Throat J2004; 83: 414–416.
15.
WillettL.L., BarneyJ., SaylorsG., DransfieldM.An unusual cause of chronic cough. Foreign body aspiration.J Gen Intern Med2006; 21: C1–3.
