title: Formation of an airway foreign body during removal of a metal tracheostomy tube: a case report.
abstract: Tracheostomy tube changes are often performed in the clinic or at the bedside without complication. We report a case in which the removal of a long-term metal tube in a clinic setting was complicated by the presence of fibrinous debris on the tube. The debris had accumulated over a period of at least 3 years. The patient was taken to the operating room, and the tube was removed. However, the fibrinous debris remained behind, leaving an airway foreign body. The foreign body was subsequently removed with an optical foreign-body extraction forceps under direct visualization. Based on our experience and on the limited amount of information available in the literature, we recommend that long-term metal tracheostomy tubes be changed not in the clinic but in the operating room, where potential complications can be more easily managed.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
authors.forename: Mitchell R
authors.initials: MR
authors.lastname: Gore
authors.forename: Austin S
authors.initials: AS
authors.lastname: Rose
mesh_terms: D000293:Adolescent; D000402:Airway Obstruction / Q000209:etiology* / Q000601:surgery; D020878:Device Removal / Q000009:adverse effects*; D005547:Foreign Bodies / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008297:Male; D014139:Tracheostomy / Q000009:adverse effects / Q000295:instrumentation*