To the Editor:—
A 78-yr-old woman was admitted to the hospital for repair of a fractured wrist, sustained in a fall. A rapid sequence induction was performed and her dentures were left in place until laryngoscopy. An uneventful general anesthetic was administered, and the patient was successfully extubated and taken to the recovery room in satisfactory condition. Several minutes after admission to the recovery room, her SpO2decreased from 99% to approximately 78%. She subsequently had a severe episode of coughing and expectorated a foreign body later identified as a Seabond® (Combe Inc., White Plains, NY) denture adhesive sheet.
Dental appliances, discovered by patient interview or examination, are left in place before intubation to aid in the performance of mask ventilation, should this prove necessary. Local pharmacies carry 15 varieties of dental adhesives, three of which use paraffin impregnated flannel sheets (two brands are shown in fig. 1). The Seabond® adhesive system consists of two separate sheets impregnated with a water-based adhesive which, when moistened, is applied to the denture and forms an efficient suction bond with the roof of the mouth. The patient expectorated one of these sheets; it is not known where the other went.
It is theorized that the sheet of adhesive, affixed to the roof of the mouth and to the denture, stayed in the mouth. It then adhered to the endotracheal tube as it passed through the oral pharynx, and was deposited in the airway. The obstruction became manifest in recovery and was dislodged by the patient's coughing, without further sequelae.