title: Airway compromise by dislodged obturator in a patient with severe trismus.
abstract: A patient presented with impending airway obstruction due to a dislodged interim maxillary obturator. The removal was complicated by the presence of severe trismus due to previous maxillectomy and recent radiotherapy. An emergency tracheotomy with the patient under local anesthetic was required to provide a definitive airway and to permit subsequent removal of the obturator with the patient under general anesthesia. The situation highlights the risks associated with interim obturators while awaiting the provision of an ideally fitted, well-retained, definitive obturator. Displaced obturators are potentially life threatening and difficult to remove in emergency situations.
authors.affiliation: Specialist Registrar in Oral and Maxillofacial Surgery, Bristol Dental Hospital, Bristol, UK. Electronic address: jcollin@doctors.org.uk.
authors.forename: John D
authors.initials: JD
authors.lastname: Collin
authors.affiliation: Clinical Lecturer and Specialist Registrar in Oral and Maxillofacial Surgery, Bristol Dental Hospital, Bristol, UK.
authors.forename: Barry G J
authors.initials: BG
authors.lastname: Main
authors.affiliation: Specialist Registrar in Restorative Dentistry, Bristol Dental Hospital, Bristol, UK.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Barber
authors.affiliation: Professor of Oral and Maxillofacial Surgery, Bristol Dental Hospital, Bristol, UK.
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Thomas
mesh_terms: D000368:Aged; D000402:Airway Obstruction / Q000209:etiology* / Q000628:therapy; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D005547:Foreign Bodies / Q000150:complications / Q000628:therapy; D006801:Humans; D008297:Male; D008437:Maxilla / Q000601:surgery; D008441:Maxillary Neoplasms / Q000601:surgery; D009960:Oropharynx / Q000473:pathology; D010158:Palatal Obturators / Q000009:adverse effects*; D056888:Patient Positioning; D014139:Tracheostomy / Q000379:methods; D014313:Trismus / Q000150:complications*