Journal of Dental Anesthesia and Pain Medicine

The Korean Dental Society of Anesthsiology (대한치과마취과학회)
권호 표지
DOI QR코드

DOI QR Code

Foreign body aspirations in dental clinics: a narrative review

  • Huh, Jin-Young (Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Chung-Ang University Gwang-Myeong Hospital, Chung-Ang University College of Medicine)
  • Received : 2022.04.01
  • Accepted : 2022.05.17
  • Published : 2022.06.01
Download PDF
⟨ Previous Next ⟩

Abstract

Foreign body aspiration can produce a medical emergency. Obstruction of the airways can be life-threatening, and complications may develop in less-severe cases if it is left untreated. Although it is more prevalent in children by approximately three times, adults can still experience it, and it is more frequently related to healthcare in adults. Objects used in dental treatment are usually placed in the oral cavity and can be ingested or inhaled by accident. Dental treatment has been identified as an important cause of the misplacement of foreign bodies in the airway. However, few reports have been published on dentistry-related foreign body aspiration. This paper discusses the disease course, management, and clinical outcomes of foreign body aspiration, especially those associated with dentistry. The patient must be examined for respiratory distress. If the patient is unstable, urgent airway management and the maneuvers for removal should be performed. Radiographs and computed tomography can help identify and locate the object. The treatment of choice is often bronchoscopy, and both flexible and rigid endoscopes can be used depending on the situation. Preventive measures need to be implemented to avoid inhalation accidents given the potential consequences. Though the incidence is rare, healthcare levels need to be enhanced to avert morbidity and mortality. Radiological evaluation and bronchoscopy are vital for management.

Keywords

References

  1. Gang W, Zhengxia P, Hongbo L, Yonggang L, Jiangtao D, Shengde W, Chun W. Diagnosis and treatment of tracheobronchial foreign bodies in 1024 children. J Pediatr Surg 2012; 47: 2004-10. https://doi.org/10.1016/j.jpedsurg.2012.07.036
  2. Foltran F, Ballali S, Passali FM, Kern E, Morra B, Passali GC, et al. Foreign bodies in the airways: a meta-analysis of published papers. Int J Pediatr Otorhinolaryngol 2012; 76: S12-9. https://doi.org/10.1016/j.ijporl.2012.02.004
  3. Fields RT, Jr., Schow SR. Aspiration and ingestion of foreign bodies in oral and maxillofacial surgery: a review of the literature and report of five cases. J Oral Maxillofac Surg 1998; 56: 1091-8. https://doi.org/10.1016/S0278-2391(98)90263-4
  4. Dibiase AT, Samuels RH, Ozdiler E, Akcam MO, Turkkahraman H.Hazards of orthodontics appliances and the oropharynx. J Orthod 2000; 27: 295-302. https://doi.org/10.1093/ortho/27.4.295
  5. Hou R, Zhou H, Hu K, Ding Y, Yang X, Xu G, et al. Thorough documentation of the accidental aspiration and ingestion of foreign objects during dental procedure is necessary: review and analysis of 617 cases. Head Face Med 2016; 12: 23. https://doi.org/10.1186/s13005-016-0120-2
  6. Gou Y, Ungvijanpunya N, Chen L, Zeng Y, Ye H, Cao L. Clear aligner vs fixed self-ligating appliances: orthodontic emergency during the 2020 coronavirus disease 2019 pandemic. Am J Orthod Dentofacial Orthop 2022; 161: e400-6. https://doi.org/10.1016/j.ajodo.2021.12.009
  7. Hadad H, de Jesus LK, Poli PP, Garcia-Junior IR, Souza F, de Oliveira FRG. Aspiration of the dental crown in an elderly patient. Radiol Case Rep 2021; 16: 2280-5. https://doi.org/10.1016/j.radcr.2021.05.041
  8. Kim E, Noh W, Panchal N. Mortality from an aspiration of dental crown during extraction. Gerodontology 2017; 34: 498-500. https://doi.org/10.1111/ger.12288
  9. Yadav RK, Yadav HK, Chandra A, Yadav S, Verma P, Shakya VK. Accidental aspiration/ingestion of foreign bodies in dentistry: a clinical and legal perspective. Natl J Maxillofac Surg 2015; 6: 144-51. https://doi.org/10.4103/0975-5950.183855
  10. Ramugade MM, Sagale AA. A review of medicolegal considerations of endodontic practice for general dental practitioners. J Int Soc Prev Community Dent 2018; 8: 283-8. https://doi.org/10.4103/jispcd.jispcd_206_18
  11. Obinata K, Satoh T, Towfik AM, Nakamura M. An investigation of accidental ingestion during dental procedures. J Oral Sci 2011; 53: 495-500. https://doi.org/10.2334/josnusd.53.495
  12. Hisanaga R, Hagita K, Nojima K, Katakura A, Morinaga K, Ichinohe T, et al. Survey of accidental ingestion and aspiration at Tokyo Dental College Chiba Hospital. Bull Tokyo Dent Coll 2010; 51: 95-101. https://doi.org/10.2209/tdcpublication.51.95
  13. Matsuo K, Palmer JB. Anatomy and physiology of feeding and swallowing: normal and abnormal. Phys Med Rehabil Clin N Am 2008; 19: 691-707, vii. https://doi.org/10.1016/j.pmr.2008.06.001
  14. Zitzmann NU, Elsasser S, Fried R, Marinello CP. Foreign body ingestion and aspiration. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999; 88: 657-60. https://doi.org/10.1016/S1079-2104(99)70004-1
  15. Centers for Disease Control and Prevention (CDC). Nonfatal choking-related episodes among children--United States, 2001. MMWR Morb Mortal Wkly Rep 2002; 51: 945-8.
  16. Baharloo F, Veyckemans F, Francis C, Biettlot MP, Rodenstein DO. Tracheobronchial foreign bodies: presentation and management in children and adults. Chest 1999; 115: 1357-62.
  17. Rafanan AL, Mehta AC. Adult airway foreign body removal. What's new? Clin Chest Med 2001; 22: 319-30. https://doi.org/10.1016/S0272-5231(05)70046-0
  18. Yang C, Hua R, Xu K, Hua X, Ma P, Zheng JN, et al. The role of 3D computed tomography (CT) imaging in the diagnosis of foreign body aspiration in children. Eur Rev Med Pharmacol Sci 2015; 19: 265-73.
  19. Soroudi A, Shipp HE, Stepanski BM, Ray LU, Murrin PA, Chan TC, et al. Adult foreign body airway obstruction in the prehospital setting. Prehosp Emerg Care 2007; 11: 25-9. https://doi.org/10.1080/10903120601023263
  20. Limper AH, Prakash UB. Tracheobronchial foreign bodies in adults. Ann Intern Med 1990; 112: 604-9. https://doi.org/10.7326/0003-4819-112-8-604
  21. Ramos MB, Fernandez-Villar A, Rivo JE, Leiro V, Garcia-Fontan E, Botana MI, et al. Extraction of airway foreign bodies in adults: experience from 1987-2008. Interact Cardiovasc Thorac Surg 2009; 9: 402-5. https://doi.org/10.1510/icvts.2009.207332
  22. Susini G, Pommel L, Camps J. Accidental ingestion and aspiration of root canal instruments and other dental foreign bodies in a French population. Int Endod J 2007; 40: 585-9. https://doi.org/10.1111/j.1365-2591.2007.01249.x
  23. Hisanaga R, Takahashi T, Sato T, Yajima Y, Morinaga K, Ohata H, et al. Accidental ingestion or aspiration of foreign objects at Tokyo Dental College Chiba Hospital over last 4 years. Bull Tokyo Dent Coll 2014; 55: 55-62. https://doi.org/10.2209/tdcpublication.55.55
  24. Tiwana KK, Morton T, Tiwana PS. Aspiration and ingestion in dental practice: a 10-year institutional review. J Am Dent Assoc 2004; 135: 1287-91. https://doi.org/10.14219/jada.archive.2004.0404
  25. Fuangtharnthip P, Pujarern P, Pachimsawat P, Loeksomphot P, Janjarussakul P, Manopatanakul S. Accidental swallowing of dental objects during pediatric dental care in thailand. J Int Soc Prev Community Dent 2021; 11: 671-7. https://doi.org/10.4103/jispcd.JISPCD_150_21
  26. Daniels J, Oremule B, Tsang W, Khwaja S. A 10-year review of the complications caused by ingested and aspirated dentures. Ear Nose Throat J 2021; 100: 574-80. https://doi.org/10.1177/0145561320917529
  27. Mise K, Jurcev Savicevic A, Pavlov N, Jankovic S. Removal of tracheobronchial foreign bodies in adults using flexible bronchoscopy: experience 1995-2006. Surg Endosc 2009; 23: 1360-4. https://doi.org/10.1007/s00464-008-0181-9
  28. Cossellu G, Farronato G, Carrassi A, Angiero F. Accidental aspiration of foreign bodies in dental practice: clinical management and prevention. Gerodontology 2015; 32: 229-33. https://doi.org/10.1111/ger.12068
  29. Reilly JS, Walter MA, Beste D, Derkay C, Muntz H, Myer CM, et al. Size/shape analysis of aerodigestive foreign bodies in children: a multi-institutional study. Am J Otolaryngol 1995; 16: 190-3. https://doi.org/10.1016/0196-0709(95)90101-9
  30. Shostak E. Foreign body removal in children and adults: review of available techniques and emerging technologies. AME Med J 2018; 3: 75. https://doi.org/10.21037/amj.2018.07.02
  31. Zur KB, Litman RS. Pediatric airway foreign body retrieval: surgical and anesthetic perspectives. Paediatr Anaesth 2009; 19: 109-17. https://doi.org/10.1111/j.1460-9592.2009.03006.x
  32. Passali D, Gregori D, Lorenzoni G, Cocca S, Loglisci M, Passali FM, Bellussi L. Foreign body injuries in children: a review. Acta Otorhinolaryngol Ital 2015; 35: 265-71.
  33. Nasir ZM, Subha ST. A five-year review on pediatric foreign body aspiration.. Int Arch Otorhinolaryngol 2021; 25: e193-9. https://doi.org/10.1055/s-0040-1709739
  34. Midulla F, Guidi R, Barbato A, Capocaccia P, Forenza N, Marseglia G, et al. Foreign body aspiration in children. Pediatr Int 2005; 47: 663-8. https://doi.org/10.1111/j.1442-200x.2005.02136.x
  35. Oguz F, Citak A, Unuvar E, Sidal M. Airway foreign bodies in childhood. Int J Pediatr Otorhinolaryngol 2000; 52: 11-6. https://doi.org/10.1016/S0165-5876(99)00283-9
  36. Paksu S, Paksu MS, Kilic M, Guner SN, Baysal K, Sancak R, Ozturk F. Foreign body aspiration in childhood: evaluation of diagnostic parameters. Pediatr Emerg Care 2012; 28: 259-64. https://doi.org/10.1097/PEC.0b013e3182494eb6
  37. Mitchell CA, Kreiger P, Goff C, Shah UK. Pediatric foreign body aspiration: a nidus for Aspergillus colonization. Int J Pediatr Otorhinolaryngol 2015; 79: 938-40. https://doi.org/10.1016/j.ijporl.2015.04.001
  38. Shah K, Guarderas J, Krishnaswamy G. Aspiration-induced pulmonary syndromes. Ann Allergy Asthma Immunol 2016; 117: 479-82. https://doi.org/10.1016/j.anai.2016.07.030
  39. Cho HK, Cho KY, Cho SY, Sohn S. Bronchial foreign body aspiration diagnosed with MDCT. Clin Exp Pediatr 2007; 50: 781-4.
  40. Dong YC, Zhou GW, Bai C, Huang HD, Sun QY, Huang Y, Han YP, Li Q. Removal of tracheobronchial foreign bodies in adults using a flexible bronchoscope: experience with 200 cases in China. Intern Med 2012; 51: 2515-9. https://doi.org/10.2169/internalmedicine.51.7672
  41. Ma W, Hu J, Yang M, Yang Y, Xu M. Application of flexible fiberoptic bronchoscopy in the removal of adult airway foreign bodies. BMC Surg 2020; 20: 165. https://doi.org/10.1186/s12893-020-00825-5
  42. Lin L, Lv L, Wang Y, Zha X, Tang F, Liu X. The clinical features of foreign body aspiration into the lower airway in geriatric patients. Clin Interv Aging 2014; 9: 1613-8.
  43. Altuntas B, Aydin Y, Eroglu A. Foreign bodies in trachea: a 25-years of experience. Eurasian J Med 2016; 48: 119-23. https://doi.org/10.5152/eurasianjmed.2015.109
  44. Swanson KL, Prakash UBS, McDougall JC, Midthun DE, Edell ES, Brutinel MM, et al. Airway foreign bodies in adults. J Bronchology Interv Pulmonol 2003; 10: 107-11.
  45. Bhattacharya M, Kallet RH, Ware LB, Matthay MA. Negative-Pressure Pulmonary Edema. Chest 2016; 150: 927-33. https://doi.org/10.1016/j.chest.2016.03.043
  46. Sehgal IS, Dhooria S, Ram B, Singh N, Aggarwal AN, Gupta D, et al. Foreign body inhalation in the adult population: experience of 25,998 bronchoscopies and systematic review of the literature. Respir Care 2015; 60: 1438-48. https://doi.org/10.4187/respcare.03976
  47. Mehta RM, Rashmi N, Bajaj P, Krishnan S, Srinivasan L. Airway stenosis related to foreign body aspiration: an under-recognized long term complication. Clin Med Insights Case Rep 2019; 12: 1179547619863816.
  48. Panigrahi B, Sahay N, Samaddar DP, Chatterjee A. Migrating foreign body in an adult bronchus: an aspirated denture. J Dent Anesth Pain Med 2018; 18: 267-70. https://doi.org/10.17245/jdapm.2018.18.4.267
  49. Oyama LC. Foreign bodies of the ear, nose and throat. Emerg Med Clin North Am 2019; 37: 121-30. https://doi.org/10.1016/j.emc.2018.09.009
  50. Fidkowski CW, Zheng H, Firth PG. The anesthetic considerations of tracheobronchial foreign bodies in children: a literature review of 12,979 cases. Anesth Analg 2010; 111: 1016-25. https://doi.org/10.1213/ANE.0b013e3181ef3e9c
  51. Pugmire BS, Lim R, Avery LL. Review of ingested and aspirated foreign bodies in children and their clinical significance for radiologists. Radiographics 2015; 35: 1528-38. https://doi.org/10.1148/rg.2015140287
  52. Pinto A, Muzj C, Gagliardi N, Pinto F, Setola FR, Scaglione M, et al. Role of imaging in the assessment of impacted foreign bodies in the hypopharynx and cervical esophagus. Semin Ultrasound CT MR 2012; 33: 463-70. https://doi.org/10.1053/j.sult.2012.06.009
  53. Lee EY, Restrepo R, Dillman JR, Ridge CA, Hammer MR, Boiselle PM: Imaging evaluation of pediatric trachea and bronchi: systematic review and updates. Semin Roentgenol 2012; 47: 182-96. https://doi.org/10.1053/j.ro.2011.12.002
  54. Saeed Bamashmos A, Heshmetzadeh Behzadi A, Elfatairy K, Megahed A, Kochar P, Hegde R. Foreign bodies of body orifices: a pictorial review. Clin Imaging 2021; 80: 180-9. https://doi.org/10.1016/j.clinimag.2021.07.006
  55. Laya BF, Restrepo R, Lee EY. Practical imaging evaluation of foreign bodies in children: an update. Radiol Clin North Am 2017; 55: 845-67. https://doi.org/10.1016/j.rcl.2017.02.012
  56. Veras TN, Hornburg G, Schner AM, Pinto LA. Use of virtual bronchoscopy in children with suspected foreign body aspiration. J Bras Pneumol 2009; 35: 937-41. https://doi.org/10.1590/S1806-37132009000900016
  57. Lawrence DA, Branson B, Oliva I, Rubinowitz A. The wonderful world of the windpipe: a review of central airway anatomy and pathology. Can Assoc Radiol J 2015; 66: 30-43. https://doi.org/10.1016/j.carj.2014.08.003
  58. Gibbons AT, Casar Berazaluce AM, Hanke RE, McNinch NL, Person A, Mehlman T, Rubin M, Ponsky TA. Avoiding unnecessary bronchoscopy in children with suspected foreign body aspiration using computed tomography. J Pediatr Surg 2020; 55: 176-81. https://doi.org/10.1016/j.jpedsurg.2019.09.045
  59. Osman EZ, Swift A. Management of foreign bodies in the ears and upper aerodigestive tract. Br J Hosp Med (Lond) 2007; 68: M189-91. https://doi.org/10.12968/hmed.2007.68.Sup11.27695
  60. Dikensoy O, Usalan C, Filiz A. Foreign body aspiration: clinical utility of flexible bronchoscopy. Postgrad Med J 2002; 78: 399-403. https://doi.org/10.1136/pmj.78.921.399
  61. Olasveengen TM, Mancini ME, Perkins GD, Avis S, Brooks S, Castren M, et al. Adult basic life support: 2020 international consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations. Circulation 2020; 142: S41-91.
  62. Berdan EA, Sato TT. Pediatric airway and esophageal foreign bodies. Surg Clin North Am 2017; 97: 85-91. https://doi.org/10.1016/j.suc.2016.08.006
  63. Hewlett JC, Rickman OB, Lentz RJ, Prakash UB, Maldonado F. Foreign body aspiration in adult airways: therapeutic approach. J Thorac Dis 2017; 9: 3398-409. https://doi.org/10.21037/jtd.2017.06.137
  64. Otero Palleiro MM, Barbagelata Lopez C, Fernandez Pretel MC, Salgado Fernandez J. Hepatic rupture after Heimlich maneuver. Ann Emerg Med 2007; 49: 825-6.
  65. Desai SC, Chute DJ, Desai BC, Koloski ER. Traumatic dissection and rupture of the abdominal aorta as a complication of the Heimlich maneuver. J Vasc Surg 2008; 48: 1325-7. https://doi.org/10.1016/j.jvs.2008.05.061
  66. Ojeda Rodriguez JA, Ladd M, Brandis D. Abdominal Thrust Maneuver. In: StatPearls. Treasure Island, FL, StatPearls Publishing. 2022.
  67. Debeljak A, Sorli J, Music E, Kecelj P. Bronchoscopic removal of foreign bodies in adults: experience with 62 patients from 1974-1998. Eur Respir J 1999; 14: 792-5. https://doi.org/10.1034/j.1399-3003.1999.14d11.x
  68. Casalini AG, Majori M, Anghinolfi M, Burlone E, D'Ippolito R, Toschi M, et al. Foreign body aspiration in adults and in children: advantages and consequences of a dedicated protocol in our 30-year experience. J Bronchology Interv Pulmonol 2013; 20: 313-21. https://doi.org/10.1097/LBR.0000000000000024
  69. Boyd M, Watkins F, Singh S, Haponik E, Chatterjee A, Conforti J, Chin R Jr. Prevalence of flexible bronchoscopic removal of foreign bodies in the advanced elderly. Age Ageing 2009; 38: 396-400. https://doi.org/10.1093/ageing/afp044
  70. Simpson FG, Arnold AG, Purvis A, Belfield PW, Muers MF, Cooke NJ. Postal survey of bronchoscopic practice by physicians in the United Kingdom. Thorax 1986; 41: 311-7. https://doi.org/10.1136/thx.41.4.311
  71. Prakash UB, Offord KP, Stubbs SE. Bronchoscopy in North America: the ACCP survey. Chest 1991; 100: 1668-75. https://doi.org/10.1378/chest.100.6.1668
  72. Boufersaoui A, Smati L, Benhalla KN, Boukari R, Smail S, Anik K, et al. Foreign body aspiration in children: experience from 2624 patients. Int J Pediatr Otorhinolaryngol 2013; 77: 1683-8. https://doi.org/10.1016/j.ijporl.2013.07.026
  73. Ganie FA, Wani ML, Ahangar AG, Lone GN, Singh S, Lone H, et al. The efficacy of rigid bronchoscopy for foreign body aspiration. Bull Emerg Trauma 2014; 2: 52-4.
  74. Dorterler ME, Kocaman OH, Gunendi T, Boleken ME. a single-center experience of pediatric foreign-body aspiration: A retrospective 4-year case series. Lung India 2019; 36: 202-6.
  75. Goyal S, Jain S, Rai G, Vishnu R, Kamath GS, Bishnoi AK, Gaude Y, Kumara V, Joshi H, Reddy R. Clinical variables responsible for early and late diagnosis of foreign body aspiration in pediatrics age group. J Cardiothorac Surg 2020; 15: 271. https://doi.org/10.1186/s13019-020-01314-9
  76. Cutrone C, Pedruzzi B, Tava G, Emanuelli E, Barion U, Fischetto D, et al. The complimentary role of diagnostic and therapeutic endoscopy in foreign body aspiration in children. Int J Pediatr Otorhinolaryngol 2011; 75: 1481-5. https://doi.org/10.1016/j.ijporl.2011.08.014
  77. Fang YF, Hsieh MH, Chung FT, Huang YK, Chen GY, Lin SM, Lin HC, Wang CH, Kuo HP. Flexible bronchoscopy with multiple modalities for foreign body removal in adults. PLoS One 2015; 10: e0118993. https://doi.org/10.1371/journal.pone.0118993
  78. Swanson KL, Prakash UB, Midthun DE, Edell ES, Utz JP, McDougall JC, Brutinel WM. Flexible bronchoscopic management of airway foreign bodies in children. Chest 2002; 121: 1695-700. https://doi.org/10.1378/chest.121.5.1695
  79. Kim K, Lee HJ, Yang EA, Kim HS, Chun YH, Yoon JS, et al. Foreign body removal by flexible bronchoscopy using retrieval basket in children. Ann Thorac Med 2018; 13: 82-5. https://doi.org/10.4103/atm.ATM_337_17
  80. Tang LF, Xu YC, Wang YS, Wang CF, Zhu GH, Bao XE, Lu MP, Chen LX, Chen ZM. Airway foreign body removal by flexible bronchoscopy: experience with 1027 children during 2000-2008. World J Pediatr 2009; 5: 191-5. https://doi.org/10.1007/s12519-009-0036-z
  81. Batra H, Yarmus L. Indications and complications of rigid bronchoscopy. Expert Rev Respir Med 2018; 12: 509-20. https://doi.org/10.1080/17476348.2018.1473037
  82. Alraiyes AH, Machuzak MS. Rigid bronchoscopy. Semin Respir Crit Care Med 2014; 35: 671-80. https://doi.org/10.1055/s-0034-1395500
  83. Goussard P, Pohunek P, Eber E, Midulla F, Di Mattia G, Merven M, et al. Pediatric bronchoscopy: recent advances and clinical challenges. Expert Rev Respir Med 2021; 15: 453-75. https://doi.org/10.1080/17476348.2021.1882854
  84. Abraham ZS, Kahinga AA, Mapondella KB, Massawe ER, Ntunaguzi D. Spontaneous expulsion of an intrabronchial sharp metallic foreign body and migration to the gastrointestinal tract at Muhimbili National Hospital: case report and literature review. Int J Surg Case Rep 2020; 72: 423-5. https://doi.org/10.1016/j.ijscr.2020.05.100
  85. Ameku K, Higa M. Spontaneous expulsion and migration of a bronchial foreign body: a flustering rare dental accident. Int J Case Rep Imag 2017; 8: 668-71. https://doi.org/10.5348/ijcri-2017104-CR-10843
  86. Robinson FG, Ray DS, Kalim S. Impression material lodged in the hypopharynx: a clinical report. J Prosthet Dent 2021: 1-4.
  87. Arana Ribeiro J, Martins Natal R, Matos Gomes R. Dental implant screwdriver aspiration. Pulmonology 2022; 28: 239-40. https://doi.org/10.1016/j.pulmoe.2022.01.003
  88. Araujo SCS, Bustamante JED, de Souza AAB, Peixoto LC, Amaral MBF. Aspiration of dental items: case report with literature review and proposed management algorithm. J Stomatol Oral Maxillofac Surg 2021; 1: 1-7.
  89. Selin K, Gozde I, Gunbay T, Kahraman S, Celik F. Implant screwdriver aspiration during dental procedure at a geriatric patient: a case report. Ege Tip Dergisi 2022; 61: 111-4. https://doi.org/10.19161/etd.1086254
  90. Sopena B, Garcia-Caballero L, Diz P, De la Fuente J, Fernandez A, Diaz JA. Unsuspected foreign body aspiration. Quintessence Int 2003; 34: 779-81.
  91. Israel HA, Leban SG. Aspiration of an endodontic instrument. J Endod 1984; 10: 452-4. https://doi.org/10.1016/S0099-2399(84)80268-X
  92. de Lima A, Kheir F, Majid A, Pawlowski J. Anesthesia for interventional pulmonology procedures: a review of advanced diagnostic and therapeutic bronchoscopy. Can J Anaesth 2018; 65: 822-36. https://doi.org/10.1007/s12630-018-1121-3
  93. Du Rand IA, Blaikley J, Booton R, Chaudhuri N, Gupta V, Khalid S, et al. British Thoracic Society guideline for diagnostic flexible bronchoscopy in adults: accredited by NICE. Thorax 2013; 68 Suppl 1: i1-i44. https://doi.org/10.1136/thoraxjnl-2013-203618
  94. Lee H, Choe YH, Park S. Analgosedation during flexible fiberoptic bronchoscopy: comparing the clinical effectiveness and safety of remifentanil versus midazolam/propofol. BMC Pulm Med 2019; 19: 240. https://doi.org/10.1186/s12890-019-1004-6
  95. Crawford M, Pollock J, Anderson K, Glavin RJ, MacIntyre D, Vernon D. Comparison of midazolam with propofol for sedation in outpatient bronchoscopy. Br J Anaesth 1993; 70: 419-22. https://doi.org/10.1093/bja/70.4.419
  96. Hwang J, Jeon Y, Park HP, Lim YJ, Oh YS. Comparison of alfetanil and ketamine in combination with propofol for patient-controlled sedation during fiberoptic bronchoscopy. Acta Anaesthesiol Scand 2005; 49: 1334-8. https://doi.org/10.1111/j.1399-6576.2005.00842.x
  97. Pertzov B, Krasulya B, Azem K, Shostak Y, Izhakian S, Rosengarten D, et al. Dexmedetomidine versus propofol sedation in flexible bronchoscopy: a randomized controlled trial. BMC Pulm Med 2022; 22: 87. https://doi.org/10.1186/s12890-022-01880-9
  98. Magazine R, Sisupalan KN, Surendra VU, Chogtu B, Acharya PR, Guddattu V. Effect of bronchoscopistdirected sedation and other factors on patient comfort during diagnostic flexible bronchoscopy. Scientifica (Cairo) 2022; 2022: 8643844.
  99. Tariq A, Hill NS, Price LL, Ismail K. Incidence and nature of respiratory events in patients undergoing bronchoscopy under conscious sedation. J Bronchology Interv Pulmonol 2022: 1-7.
  100. Jo YY, Kwak HJ. Sedation strategies for procedures outside the operating room. Yonsei Med J 2019; 60: 491-9. https://doi.org/10.3349/ymj.2019.60.6.491
  101. Pathak V, Welsby I, Mahmood K, Wahidi M, MacIntyre N, Shofer S. Ventilation and anesthetic approaches for rigid bronchoscopy. Ann Am Thorac Soc 2014; 11: 628-34. https://doi.org/10.1513/AnnalsATS.201309-302FR
  102. Liao R, Li JY, Liu GY. Comparison of sevoflurane volatile induction/maintenance anaesthesia and propofol-remifentanil total intravenous anaesthesia for rigid bronchoscopy under spontaneous breathing for tracheal/bronchial foreign body removal in children. Eur J Anaesthesiol 2010; 27: 930-4. https://doi.org/10.1097/EJA.0b013e32833d69ad
  103. Malherbe S, Whyte S, Singh P, Amari E, King A, Ansermino JM. Total intravenous anesthesia and spontaneous respiration for airway endoscopy in children-a prospective evaluation. Paediatr Anaesth 2010; 20: 434-8. https://doi.org/10.1111/j.1460-9592.2010.03290.x
  104. Tschiedel E, Eckerland M, Felderhoff-Mueser U, Dohna-Schwake C, Stehling F. Sedation for bronchoscopy in children: a prospective randomized double-blinded trial. Pediatr Pulmonol 2021; 56: 1221-9. https://doi.org/10.1002/ppul.25235
  105. Umesan UK, Chua KL, Balakrishnan P. Prevention and management of accidental foreign body ingestion and aspiration in orthodontic practice. Ther Clin Risk Manag 2012; 8: 245-52. https://doi.org/10.2147/TCRM.S30639
  106. Hellyer P, Radford D. An evaluation of defensive dentistry: w(h)ither the profession? Br Dent J 2017; 223: 885-8. https://doi.org/10.1038/sj.bdj.2017.996
  107. Cameron SM, Whitlock WL, Tabor MS. Foreign body aspiration in dentistry: a review. J Am Dent Assoc 1996; 127: 1224-9. https://doi.org/10.14219/jada.archive.1996.0415
  108. Ahmed HM, Cohen S, Levy G, Steier L, Bukiet F. Rubber dam application in endodontic practice: an update on critical educational and ethical dilemmas. Aust Dent J 2014; 59: 457-63. https://doi.org/10.1111/adj.12210
  109. Doh RM. Foreign body aspiration during dental treatment under general anesthesia: A case report. J Dent Anesth Pain Med 2019; 19: 119-23. https://doi.org/10.17245/jdapm.2019.19.2.119
  110. Jeon HS, Lee JH. Prevention and management of foreign body ingestion and aspiration during the dental treatment. J Dent Rehabil Appl Sci 2018; 34: 63-71. https://doi.org/10.14368/jdras.2018.34.2.63
  111. Ismael G, Alameida LD, Lacerda TSP. Prevention from swallowing or aspiration in dentistry for elderly patients. MOJ Gerontol Ger 2018; 3: 106-8.
  112. Jillela S, Subrahmanyam R. A safer technique of nasogastric tube insertion in a patient with basilar skull fractures. Br J Anaesth 2015; 115(eLetters Supplement).
  113. Madan K, Aggarwal AN, Bhagat H, Singh N. Acute respiratory failure following traumatic tooth aspiration. BMJ Case Rep 2013; 2013: bcr2012008393.
  114. Soysal O, Kuzucu A, Ulutas H. Tracheobronchial foreign body aspiration: a continuing challenge. Otolaryngol Head Neck Surg 2006; 135: 223-6. https://doi.org/10.1016/j.otohns.2005.09.035
  115. Pasaoglu I, Dogan R, Demircin M, Hatipoglu A, Bozer AY. Bronchoscopic removal of foreign bodies in children: retrospective analysis of 822 cases. Thorac Cardiovasc Surg 1991; 39: 95-8. https://doi.org/10.1055/s-2007-1013940
  116. De Palma A, Brascia D, Fiorella A, Quercia R, Garofalo G, Genualdo M, et al. Endoscopic removal of tracheobronchial foreign bodies: results on a series of 51 pediatric patients. Pediatr Surg Int 2020; 36: 941-51. https://doi.org/10.1007/s00383-020-04685-1