A potential danger of flexible endoscopy sheaths: a detached tip and how to retrieve it.
OBJECTIVE
To report an unrecognised complication of fibre-optic nasendoscopy, and its management.


METHODS
A protective, transparent nasendoscopy sheath is often used to reduce nasendoscope 'downtime' and to prevent cross infection, with minimal effect on the obtained image quality. We report the case of a subcutaneous tracheostomy procedure during which, without undue strain, the tip of the sheath became detached and acted as a foreign body within the trachea. A urological stone retrieval basket was used to retrieve the sheath, after failure of conventional methods.


CONCLUSIONS
Clinicians should be aware that any instrument introduced into the airway has the potential to fail and in the process produce a foreign body which may cause serious complications. The urological stone retrieval basket may be a useful addition to the current set of instruments used to deal with difficult airway foreign bodies.
Awad
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Z
Department of Otolaryngology, Head and Neck Surgery, St Bartholomew's Hospital, London, UK. mail@zaidawad.com
Pothier
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DD
D020878:Device Removal; D019723:Endoscopes / Q000009:adverse effects*; D004868:Equipment Failure; D005547:Foreign Bodies / Q000209:etiology* / Q000628:therapy; D006801:Humans; D013525:Surgical Instruments / Q000009:adverse effects*; D014132:Trachea; D014139:Tracheostomy