Successful Removal of an Aspirated Tooth by Chest Physiotherapy

A 63-year-old man required emergency endotracheal intubation and mechanical ventilation for complications of acute myocardial infarction. After the patient was extubated, a tooth, which had apparently been dislodged during intubation and had remained in the posterior pharynx, was aspirated into the right lower-lobe bronchus. Vigorous chest percussion and postural drainage administered every 2 hours enabled the patient to cough up the tooth 17 hours after its discovery. He subsequently recovered uneventfully from both the myocardial infarction and the foreign-body aspiration. Although bronchoscopy, with either a rigid or a flexible instrument, is currently the treatment of choice for an adult patient with a foreign object in the lower airway, chest physiotherapy could represent a less invasive, less expensive initial therapy for patients who can cough and who can be moved into the appropriate drainage position. (Respir Care 1986;31:1099-1101.)