ASPIRATION OF NASAL RING IN YOUNG HEALTHY FEMALE ADULT

Abstract

SESSION TITLE: Medical Student/Resident Procedures Posters SESSION TYPE: Med Student/Res Case Rep Postr PRESENTED ON: October 18-21, 2020 INTRODUCTION: Unlike in children and Elderly, foreign body aspiration rare in adults1. With headscarf pin and dental prosthesis being the most reported objects. A common complication of nasal piercing is a local infection and skin reaction2. However, aspiration of foreign objects (FB) could cause recurrent pneumonia. Here we describe a rare case of aspiration of nasal piercing in a young healthy adult. CASE PRESENTATION: A 26-year-old healthy female who presented to the emergency department with a chief complaint of FB stuck in her throat. She stated that she had a nose ring (NR), and while she was removing it, she got the urge to sneeze and inhaled sharply, which caused her to inhale her NR. She complained of mild foreign body sensation in the back of her throat and minor nonproductive cough but denied any hemoptysis or shortness of breath and no wheezing was noted on physical exam. X-ray neck was clear, but an X-ray chest showed curvilinear FB suspected in the region of the right main bronchus. During our assessment, all her vitals were stable and within normal limits. Handstand with back tapping was unsuccessful. Therefore, she was taken to the operating room for flexible fiberoptic bronchoscopy for FB retrieval under general anesthesia. The airway was secured by a laryngeal mask airway (LMA). The bronchoscope found NR located in the right main bronchus. Alligator jaw forceps were used to bring the NR above the vocal cords since NR size was small enough (1 cm in diameter) to pass through the LMA, but the NR got snared by the arytenoid cartilage. Glidoscope was used to visualize the ring and Forceps were used to safely remove it. Post-procedurally she was discharged home in stable condition. DISCUSSION: Generally rigid bronchoscopy is the tool of choice to manipulate the airway in these situations by an interventional pulmonologist or by a surgeon3, however, if they are not readily available at bedside, flexible bronchoscopy is a fairly safe way to remove FB under general anesthesia. CONCLUSIONS: Although it is extremely rare for aspiration of NR, it could potentially cause serious complications such as recurrent pneumonia. A certified clinician to use flexible bronchoscopy should be aware that flexible bronchoscopy is a fast and relatively safe tool to retrieve small FB. Reference #1: 1.Oliveira Matos C, Sousa MM. Foreign Body Aspiration in the Elderly. Acta Med Port 2016;29:340-3. Reference #2: 2.Hackenberg B, Grosse-Buning S, Hammes S, Strieth S. [Complications of cosmetic piercings and tattoos in the head and neck region]. HNO 2020;68:131-40. Reference #3: 3. Acharya K. Rigid Bronchoscopy in Airway Foreign Bodies: Value of the Clinical and Radiological Signs. Int Arch Otorhinolaryngol. 2016;20(3):196-201. DISCLOSURES: No relevant relationships by Mutsumi Kioka, source=Admin input No relevant relationships by Marwan Mashina, source=Web Response