Endobronchial use of gastrointestinal retrieval net for an aspirated dental crown

Abstract

Introduction/aim: Flexible fiberoptic bronchoscopy is generally the first line procedure for airway foreign body removal. However, removal may be challenging when surface and/or other characteristics make grasping the object difficult. We present a case in which we used a gastrointestinal retrieval net to successfully extract a dental crown, a type of foreign body with difficult-to-grasp surface characteristics. Methods: A 72-year-old male aspirated a dental crown during an attempted molar crown fitting. Semi-emergent flexible fiberoptic bronchoscopy was undertaken using an Olympus bronchoscope with a 2.8mm working channel. Attempts at retrieval using standard forceps, and a four-wire airway retrieval basket were unsuccessful. The retrieval net (RescueNet, Boston Scientific) is a device used in gastrointestinal procedures to retrieve foreign objects, food boluses and tissue fragments. The device's external catheter is 2.5mm in diameter and is passed through the working channel of an endoscope. The handle operates in a similar manner to conventional biopsy forceps and deploys a one-sided fishnet mesh basket with an adjustable string collar that can be manipulated to enclose a target. Results: The dental crown was easily removed with the retrieval net on the second attempt. Upon review of the literature, endobronchial usage of retrieval nets was found to be rare. Conclusion: Clinicians should be aware that gastrointestinal retrieval nets are an option for the retrieval of airway foreign bodies.

Keywords

• Aspiration
• Bronchoscopy
• Foreign body
• Dental crown
• Retrieval net