JRSM >
Volume 97, Number 5 >
Pp. 254
Department of Otolaryngology, Royal Alexandra Hospital, Corsebar Road, Paisley PA2 9PN, Scotland, UK. E-mail: ncalder{at}hotmail.com
Mr Hashmi and his colleagues present an excellent discussion of the problems of diagnosing and managing swallowed partial dentures (February 2004 JRSM1). Management can be challenging even when the diagnosis is straightforward. We recently saw a man of 34 who had swallowed a set of partial upper dentures which contained a wire to fix the plate to the teeth. He had swallowed them accidentally while eating a meal. The dentures lodged in the upper oesophagus, at the level of the sternal notch, and the wire was easily visible on X-ray. Oesophagoscopy revealed the dental plate just below the level of the cricopharyngeus but multiple attempts at removal, with various instruments, were unsuccessful. Sometimes the answer is to split the plate and remove it in pieces, but even with heavy denture shears the material proved too hard to cut. Therefore an oesophagotomy was performed through a lateral pharyngeal approach. The wire was seen to penetrate the lateral oesophageal wall. The patient recovered without incident and was planning to discuss more suitable dentures with his dentist.
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