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Successful experience in dealing with tooth aspiration after extubation: a case report
Xiao-Juan Jiang1, Wei-Yi Zhang1
1Department of Anesthesia, West China Hospital, Sichuan University, Chengdu, China.
Annals of Palliative Medicine
|April 25, 2021
Summary
Tooth aspiration after extubation is a rare but serious complication. A new VICTOR flowchart helps prevent tooth loss and aids in locating missing teeth during surgery.
Area of Science:
- Anesthesiology
- Critical Care Medicine
- Otorhinolaryngology
Background:
- Dental injury or loss during endotracheal intubation/extubation is common.
- Tooth aspiration poses risks like airway obstruction and aspiration pneumonitis, especially post-extubation.
- Current guidelines for managing loose or missing teeth perioperatively are lacking.
Observation:
- A 67-year-old male developed a loose left maxillary incisor during general anesthesia for laparoscopic colectomy.
- The loose tooth was missing post-surgery, necessitating a challenging search.
- A chest X-ray identified the tooth as a foreign body in the trachea.
Findings:
- The aspirated tooth was successfully removed via fiber-bronchoscopy.
- The patient recovered without complications and was discharged on postoperative day three.
- A novel flowchart, "VICTOR," is proposed for perioperative tooth loss prevention and management.
Implications:
- The VICTOR flowchart offers a structured approach to prevent dental aspiration during surgery.
- Timely identification and removal of aspirated teeth are crucial for patient safety.
- Standardized protocols can mitigate risks associated with dental complications in surgical patients.
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