Aspirated Prosthesis

The sudden onset of shortness of breath prompted a 53-year-old man to seek medical attention. He had a history of total laryngectomy for laryngeal cancer and placement of a tracheoesophageal prosthesis.

The patient reported that he was unable to breathe in completely and had to take small breaths. He also complained of sharp pain in the right lower chest on deep inspiration. He denied orthopnea, hemoptysis, palpitations, cough, fever, and nausea. The review of systems was positive for baseline dysphagia and otalgia.

He was hemodynamically stable. Respiration rate was 22 breaths per minute, and pulse oximetry revealed an oxygen saturation of 99% on room air. Pertinent physical examination findings included a widely patent laryngectomy stoma, clear breath sounds bilaterally except for reduced air entry on the right lung base, and normal heart sounds.

Close inspection of a chest radiograph revealed a radiolucent piece of tracheoesophageal prosthesis in the right mainstem bronchus (arrow). The aspirated prosthesis was removed by flexible bronchoscopy without any difficulty. The patient’s dyspnea improved, and a new prosthesis was placed.