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August 18, 2016

Misdiagnosis of a Tracheal Foreign Body of Decades-Long Duration

Author Affiliations
  • 1Head and Neck Institute, Cleveland Clinic Foundation, Cleveland, Ohio
JAMA Otolaryngol Head Neck Surg. Published online August 18, 2016. doi:10.1001/jamaoto.2016.2050

Foreign body (FB) aspiration is a life-threatening situation that accounts for approximately 4800 deaths per year in the United States.1 In cases of nonasphyxiating FBs, symptoms may be more indolent and diagnosis can be significantly delayed. We describe a unique scenario of a retained tracheal FB.

A woman in her 40s presented to our clinic for treatment of “subglottic stenosis.” She reported a life-long medical history of dyspnea and wheezing attributed to poorly controlled asthma, as well as severe halitosis. The patient had several successful pregnancies, but had never been intubated. Several months prior to our evaluation, she noted increasing severity of her symptoms, which prompted further outside investigation by means of computed tomography (CT) scans of the neck and chest. This demonstrated a partially obstructive lesion in the oblique plane beginning at the subglottis and extending to the first tracheal ring (Figure 1). She was referred to our clinic for dilation of the subglottis.

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