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Postextubation foreign body aspiration: a case report

S L Walton1

  • 1Wyoming Valley Health Care System School of Anesthesia, Wilkes Barre, Pennsylvania, USA.

AANA Journal
|April 1, 1997
PubMed
Summary
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A dislodged nasal pack after endoscopic sinus surgery was aspirated, leading to a life-threatening emergency. Prompt fiberoptic bronchoscope retrieval saved the patient from this foreign body aspiration complication.

Area of Science:

  • Otolaryngology
  • Anesthesiology
  • Critical Care Medicine

Background:

  • Endoscopic sinus surgery (ESS) is a common procedure, but potential complications require vigilance.
  • Nasal packs are used post-operatively, typically removed within 24 hours, to prevent bleeding and support healing.
  • Standard protocols aim to secure nasal packs to prevent dislodgement and aspiration.

Observation:

  • A healthy young male undergoing ESS experienced unexpected hypoxia and stridor post-extubation.
  • High ventilatory pressures and emergency reintubation were necessary, indicating a critical airway obstruction.
  • Intraoperative findings revealed a dislodged nasal pack aspirated into the tracheobronchial tree.

Findings:

  • The aspirated nasal pack caused a severe foreign body aspiration event, presenting as a life-threatening emergency.

Related Experiment Videos

  • The patient exhibited signs of compromised oxygenation, hypercarbia, tachycardia, and hypertension.
  • Successful retrieval of the aspirated pack was achieved using fiberoptic bronchoscopy.
  • Implications:

    • This case highlights a rare but potentially fatal complication of ESS involving nasal pack aspiration.
    • It underscores the importance of meticulous post-operative assessment and the potential for unexpected pack dislodgement.
    • Reinforces the critical role of timely diagnosis and intervention with fiberoptic bronchoscopy in managing airway foreign bodies.