A 70-year-old woman has been operated on in the Vithas Hospital in Vigo for the removal of a titanium screw of dental use of her bronchi, which the patient had inadvertently aspirated several months earlier.
The presence of the foreign body caused her repeated respiratory infections over several months and she had to undergo a bronchoscopyby the service of Pneumology.
Doctor Antonio Fernández Rodríguez removed the screw, which had been located a few months earlier by means of a chest x-rayand presented the video of the intervention to the III interventional pulmonology video contest of the Spanish Society of Pulmonology and Thoracic Surgery.
The origin of this situation dates back almost a year, when the woman was subjected to a dental surgery for the placement of some bone implants. Two months later, the healing caps were placed and, one month later, the definitive prostheses were fitted.
The woman was unaware that she had aspirated a foreign body, which turned out to be a titanium screw, one of those commonly used in dental implants, 9 mm long by 5.5 mm in diameter. The screw was aspirated at some point between the second and third intervention, so it was lodged in a bronchus for about 8 months.
This was the surgical intervention
The woman began to have respiratory infections and, after an x-ray and a TACin which a foreign body was observed in the right lower lobe of the lung, she was referred to Dr. Fernández Rodríguez.
The patient suffers from COPD and bilateral bronchiectasis (dilated and inflamed bronchi) colonized by the bacteria Proteus mibrillisThat’s why I suffered so many infections. The tests revealed the presence of a foreign body in the bronchi, but it had not been possible to identify what it was.
Finally, a bronchoscopy was carried out, in which the anesthetist and nurse also participated, given the woman’s age and complications. With the help of video source coscopythe doctor was able to locate the screw, which was fortunately free of tissue, and was able to remove it with forceps.
Since there are no cases of titanium intrabronchial foreign bodies in the medical literature, Vithas Vigo’s pulmonologist has concluded that “titanium possibly does not cause a foreign body reaction in the airway and does not form granulation tissue.”
In this regard, it has recognized that, finally, the extraction was “easier than expected”. The intervention was ambulatory and the patient was discharged a few hours after the intervention, being asymptomatic.