Introduction: Foreign body aspiration is a medical emergency, especially in elderly patients with underlying chronic respiratory diseases such as chronic obstructive pulmonary disease (COPD). In such individuals, abnormal airway anatomy and limited pulmonary reserve amplify the risks. We report a case of successful bronchoscopic removal of a metallic dental instrument from the bronchus of a 78-year-old woman with emphysematous lungs, highlighting the importance of rapid, minimally invasive intervention.
Description: A 78-year-old woman undergoing elective dental veneer placement aspirated a dental drill bit during the procedure. She was transferred immediately to the emergency department. On arrival, she reported throat discomfort but denied dyspnea or chest pain. Vitals were stable: BP 130/67 mmHg, HR 59 bpm, RR 16/min, SpO₂ 95% on room air. Laboratory findings were unremarkable. Chest radiography revealed a 3 × 0.5 cm radiopaque foreign body in the bronchus intermedius. An emergent flexible bronchoscopy was performed. The foreign body, consistent with a dental drill bit, was visualized and successfully retrieved from the bronchus. Mild blood-streaked secretions were observed, but no signs of purulence or endobronchial damage were noted. The patient remained stable and asymptomatic post-procedure and was discharged with no complications.
Discussion: Although foreign body aspiration is more commonly reported in pediatric populations, it poses significant risks to elderly patients with COPD. In this case, the rapid coordination between emergency and pulmonary services enabled timely intervention with flexible bronchoscopy—the preferred first-line technique due to its safety and efficacy. This case underscores the need for aspiration precautions during dental procedures in high-risk individuals. It also highlights the value of maintaining interprofessional readiness for airway emergencies, where minimally invasive bronchoscopic techniques can rapidly restore airway patency and minimize morbidity.
