  |
|
 |
|
Case Report
| ||||||
| Missed chronic impaction of dental crowns in the hypopharynx of a neurologically devastated child | ||||||
| Michael Zaki1, Soroush Zaghi2, Jonathan Ghiam3, Alisha West4 | ||||||
|
1BS, Medical Student, Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA (DGSOM), Los Angeles, CA, USA.
2MD, Chief Resident, Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA (DGSOM), Los Angeles, CA, USA. 3BA, Student Researcher, Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA (DGSOM), Los Angeles, CA, USA. 4MD, Assistant Professor-In-Residence, Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA (DGSOM), Los Angeles, CA, USA. | ||||||
| ||||||
|
[HTML Full Text]
[PDF Full Text]
[Print This Article]
[Similar article in Pumed] [Similar article in Google Scholar] 
|
| How to cite this article |
| Zaki M, Zaghi S, Ghiam J, West A. Missed chronic impaction of dental crowns in the hypopharynx of a neurologically devastated child. Int J Case Rep Images 2015;6(1):29–33. |
|
Abstract
|
|
Introduction:
Ingested foreign objects that impacted in the upper aero-gastrointestinal tract are fairly common and potentially serious problems. Dental objects are the most common ingested foreign bodies. Longstanding impacted foreign objects are complicated by failure to thrive or recurrent aspiration pneumonia and other serious complications such as viscus perforation, neck infections, hemorrhage, or esophago-aortic and tracheoesophageal fistulas.
Case Report: An eight-year-old neurologically devastated boy with tongue biting and bruxism was brought into the emergency department for evaluation of two foreign bodies found incidentally on modified barium swallow study. Plain radiography of the neck soft tissue showed two radiopaque densities within the hypopharynx. The foreign objects were removed in the operating room under anesthesia using direct laryngoscopy and forceps and gross pathology was consistent with two golden dental crowns. The patient appeared to be at his baseline with respect to swallowing, breathing, and pain despite the fact that the crowns had been impacted for at least eight months based upon review of prior available radiological images. Conclusion: We hypothesize that our patient's continuous bruxism and ill-fitting crowns led to dislodgement and impaction of the crowns. His neurologic impairment and lack of gag reflex may have allowed the dental crown impaction to remain asymptomatic. Impaction of dental prosthetics in the upper aero-gastrointestinal tract may be masked and under-recognized in children, psychiatric patients, and individuals with neurologic impairment. Careful and regular evaluation of dental prosthetics in this population should be undertaken to prevent complications secondary to ingestion. | |
|
Keywords:
Accidental ingestion, Aero-gastrointestinal tract, Dental prosthesis, Foreign body impaction, Hypopharynx, Neurological impairment, Psychiatric patient
| |
|
[HTML Full Text]
[PDF Full Text]
|
|
Author Contributions
Michael Zaki – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Soroush Zaghi – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published Jonathan Ghiam – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published Alisha West – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published |
|
Guarantor of submission
The corresponding author is the guarantor of submission. |
|
Source of support
None |
|
Conflict of interest
Authors declare no conflict of interest. |
|
Copyright
© 2015 Michael Zaki et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information. |
|
|