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Inhaled Foreign Body Management — FRCA Final MCQ

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ModerateAnaesthetic Equipment & SafetyInhaled Foreign Body ManagementFRCA Final

A 45-year-old man (ASA I) is having dental surgery under nasotracheal intubation. The surgeon accidentally displaces a tooth posteriorly. It is not visible in the oropharynx. CXR shows the tooth in the right main bronchus. What is the next step?

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Correct answer: C — Urgent rigid bronchoscopy and retrieval

An inhaled foreign body (tooth) in the right main bronchus requires urgent removal by rigid bronchoscopy. Rigid bronchoscopy provides superior visualisation, airway protection, ventilation capability, and instrument access for retrieval compared to flexible bronchoscopy. Teeth are radio-opaque and easily located on CXR. The right main bronchus is the most common site for inhaled foreign bodies due to its wider diameter and more vertical alignment. Delay in removal risks: pneumonia, lung abscess, bronchiectasis, and airway obstruction. The incident must be reported (DATIX, duty of candour).

Reference: RCOA – 2023 – Dental damage guidelines; AAGBI – 2018 – Dental injury management