Man dentures stuck in throat at James Paget Hospital

This undated X-ray image provided by the BMJ in August 2019 shows dentures stuck in the throat of a 72-year-old patient. They became lodged in his throat during surgery and weren’t discovered until eight days later

The man's case brings attention to the risks of leaving dentures in the mouths of patients undergoing surgeries that require general anesthesia, wrote the article's author, Harriet A. Cunniffe, an otolaryngologist at James Paget University Hospitals NHS Foundation Trust in the United Kingdom.

They got stuck in his throat - and were only discovered eight days later. And they sent him home with antibiotics and other drugs.

Six days later, he was in the emergency room.

However his symptoms worsened and, after two days of taking the prescribed medication, he was admitted to hospital with what doctors believed to be aspiration pneumonia - a severe chest infection that occurs when food, stomach acid or saliva is inhaled into the lungs. He told doctors he hadn't been able to swallow any of his prescribed medicines. They found a semi-circular object lying across his vocal cords, which had caused internal swelling and blistering, according to a report in the BMJ Case Reports medical journal.

When the doctors mentioned the object to the man, he said that his dentures had gone missing after his surgery eight days earlier. But six days later a bout of bleeding prompted his return. However, after six days, he had started to feel some pain and was struggling to swallow, so returned to A&E.

Nine days after he was discharged once more, he returned with further bleeding which required emergency surgery as the source of the bleed was a torn artery in the wound. Doctors eventually determined that the bleeding was due to internal wound tissue around the blistering caused by his false teeth.

But by this time the patient had lost so much blood that he required a blood transfusion. Now, as he told doctors that he couldn't swallow the medication and was still coughing blood, he spoke in a "hoarse breathy voice", according to the report.

Cunniffe, the report's author, wrote that the man's case "highlights a number of key learning points for anesthetists, theatre staff, emergency physicians and ear, nose and throat (ENT) surgeons alike", but noted that it is not the first of its kind.

The authors of the study wrote: "There are no set national guidelines on how dentures should be managed during anaesthesia, but it is known that leaving dentures in during bag-mask ventilation allows for a better seal during induction (when the anaesthetic is being infused), and therefore many hospitals allow dentures to be removed immediately before intubation (when a tube is inserted into the airway to assist breathing)".

The report concluded that all members of surgical teams must be aware of dentures before and after surgery, as well know what to do with them during the procedure.

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