Bradley J Petty
Adam E Singleton
Merry E Sebelik
University of Tennessee Health Sciences Center
Objective: 1. Describe an unusual case of a retained stoma button in a laryngectomy patient. 2. Highlight the dangers of modifying airway devices and their difficulty in being identified radiographically.Methods: A case report of a laryngectomy patient who presented with fever and increasing productive cough and found to have a modified stoma button lodged within his airway. Photographs of the prosthesis were obtained.Results: A laryngectomy patient presented with fevers, productive cough and shortness of breath. The patient had a stoma button that he had modified to assist with the use of a tracheoesophageal prosthesis that he had lost six months prior to this episode. During that time frame, the patient had been treated for an episode of pneumonia and had a chest x-ray obtained with no foreign body being identified. Flexible tracheobronchoscopy was performed and a plastic tube was identified lodged at the left main stem along with purulent secretions. This was removed with McGill forceps in the clinic.Conclusions: Most reported cases of laryngectomy foreign body aspirations involve voice prostheses or portions of stoma cleaning kits. Only a few cases report aspiration of stoma buttons. This unique case highlights the danger of modifying airway devices. The patient had modified his stoma button in such a way that it no longer retained sufficient integrity to prevent aspiration. Additionally, it is important to highlight that many devices used within and around the stoma are radiolucent allowing for missed or delayed diagnosis, especially when clinical suspicion is low.