Foreign body ingestion is a common occurrence in young children and may present with a wide range of nonspecific symptoms. Diagnosis can be challenging, particularly when the ingestion is unwitnessed and imaging studies are inconclusive. We present a case of a child with recurrent hospital admissions for respiratory symptoms that did not improve with standard management, along with repeated choking episodes that led the family to rely solely on milk feeds and avoid solid foods. Despite normal chest X-rays and magnetic resonance imaging findings, upper gastrointestinal endoscopy revealed an aluminum soda-can cover lodged in the upper esophagus.

With the rising popularity of minimally invasive facial aesthetic procedures, injection-related complications in the cranio-maxillofacial region pose an increasing diagnostic and therapeutic challenge. We report a rare case of refractory delayed-onset inflammatory nodules in a 36-year-old woman with a self-reported allergic history following sequential injections of polyvinyl alcohol (PVA), poly-L-lactic acid (PLLA), and polycaprolactone (PCL) based biostimulatory fillers in distinct facial subunits. More than one year post-injection, the patient developed progressive erythema, induration, tenderness, and nodular swelling at multiple sites. Lesions showed poor response to intralesional corticosteroids and aspiration. High-frequency ultrasonography and magnetic resonance imaging facilitated precise lesion mapping and guided surgical excision. Site-specific histopathology revealed retained particulate material with foreign-body giant cells, granulomatous inflammation, and collagen-rich fibrosis. Exploratory transcriptomic profiling and immunofluorescence supported a shared inflammatory-fibrotic response but remained hypothesis-generating. This case underscores the clinical importance of refractory multisite foreign-body granulomas after sequential exposure to different persistent or biostimulatory injectable materials. It raises, but does not establish, the possibility of a host-related contribution and highlights the value of detailed injection history, multimodal imaging, site-specific histopathology, judicious material selection, and individualized management.

Dental dislodgement during oral and maxillofacial surgery is an uncommon, but potentially serious complication. We report a case of intraoperative tooth loss with asymptomatic supraglottic retention during oral surgery under general anesthesia. A 55-year-old man underwent bilateral maxillary endoscopic sinus surgery (MESS) under general anesthesia. A severely mobile mandibular tooth was missing during surgery, although the ventilation and hemodynamic parameters remained stable. As the patient showed no evidence of airway compromise and the location of the tooth was uncertain, radiographic localization was performed after completion of the procedure. Portable radiograph revealed a tooth-shaped foreign body in the laryngeal region. Subsequent videolaryngoscopic examination revealed a tooth lodged beneath the epiglottis and above the vocal cord. The tooth was successfully removed using Magill forceps and the patient recovered without any respiratory complications. This case highlights that a dislodged tooth may remain undetected in the supraglottic airway despite stable respiratory parameters. Radiographic localization, followed by targeted video laryngoscopic retrieval, has enabled successful management.

Undiagnosed and retained aspirated foreign bodies are a well-recognized cause of pulmonary morbidity, yet diagnosis of this clinical entity is often delayed, particularly when the foreign body is radiolucent, or the history of aspiration cannot be recalled. We report the longest documented case of a retained airway foreign body to date: a 59-year-old woman who aspirated a plastic Barbie doll house cup at age 8, 51 years prior. She experienced recurrent right lower lobe (RLL) pneumonias, and CT imaging eventually revealed chronic RLL collapse and bronchial obstruction. Flexible bronchoscopy confirmed and enabled successful removal of the foreign body. This case underscores the importance of maintaining clinical suspicion for foreign body aspiration in adults with persistent or recurrent respiratory symptoms, even when the initial aspiration event occurred many years prior. It also highlights the diagnostic challenges associated with radiolucent foreign bodies and the potential for long-term pulmonary complications when diagnosis is delayed.

Airway foreign body (AFB) is commonly encountered in young children but may present atypically in adolescents, contributing to a delayed diagnosis. We report a case of a previously healthy 14-year-old male who presented after choking on a plastic water bottle cap with persistent throat discomfort but no respiratory distress. Initial evaluation, including plain radiographs, esophagram, and computed tomography (CT) of the chest, was unrevealing, and the patient was discharged after tolerating oral intake. He returned two days later with persistent symptoms and new-onset hoarseness. Re-evaluation of CT imaging with dedicated review of airway structures revealed a radiolucent foreign body within the subglottic airway. The patient underwent successful removal via direct laryngoscopy without complications. We highlight key diagnostic challenges in AFB, particularly radiolucent objects and subacute presentations in older children. Negative initial imaging and absence of overt respiratory distress may provide false reassurance. A high index of suspicion, careful image review, and early airway-directed evaluation are essential to avoid delayed diagnosis and associated complications.

The growing popularity of baby-led weaning has generated ongoing debate regarding its nutritional adequacy and safety, particularly in relation to iron-deficiency anaemia and choking. This commentary discusses findings from a recent retrospective study published in Appetite and argues that observed risks may be less related to feeding methods themselves and more reflective of gaps in professional guidance and inconsistencies in real-world implementation. By shifting the focus from method-based comparisons to feeding practices and clinical support, this commentary highlights the importance of practical, consistent and developmentally informed guidance during complementary feeding.

Acute hypoxemic respiratory failure in toddlers is most commonly associated with severe pneumonia, bronchiolitis, or foreign body aspiration. Complete obstruction of a main bronchus by mucus plugs is an uncommon but potentially life-threatening cause of unilateral lung collapse and severe hypoxemia. We report the case of a previously healthy 17-month-old boy who presented with severe respiratory distress after 3 days of fever and cough. Physical examination revealed marked respiratory distress with absent breath sounds over the left hemithorax. Chest radiography and computed tomography demonstrated complete left lung collapse without evidence of pleural effusion or foreign body. Due to rapidly worsening hypoxemia and suspected central airway obstruction, emergency flexible bronchoscopy was performed under general anesthesia via endotracheal intubation. Complete occlusion of the left main bronchus by thick mucus plugs was identified and successfully removed using suction and bronchoscopic forceps, resulting in immediate improvement in oxygenation and rapid radiologic lung re-expansion. The patient recovered fully and was discharged in 5 days without complications. This case highlights the importance of considering mucus plug-induced bronchial obstruction in toddlers presenting with sudden unilateral lung collapse and severe hypoxemia, particularly when foreign body aspiration remains a differential diagnosis. Early bronchoscopic intervention can be lifesaving and may prevent prolonged respiratory failure and associated complications.

We report a unique case of a posttraumatic iris implantation cyst with sediment containing occult glass intraocular foreign bodies detected 50 years after penetrating ocular trauma. Ultrasound biomicroscopy demonstrated foreign-body echoes with reverberation artifacts within the cyst fluid sediment, which were confirmed intraoperatively as glass particles. Cytologic analysis of the aspirate revealed epithelial cells, lymphocytes, and macrophages, while histopathologic examination of the cyst wall demonstrated nonkeratinized stratified squamous epithelium. This previously unreported presentation highlights that occult glass intraocular foreign bodies may remain clinically silent for decades and should be considered in the differential diagnosis of posttraumatic iris cysts containing sediment.

BioGlue is an albumin-glutaraldehyde surgical sealant approved by the Food and Drug Administration that is widely used across multiple surgical specialties for more than two decades. We report an unusual case in which the application of BioGlue during a cervical lymph node dissection resulted in a mass-forming inflammatory reaction that radiographically mimicked recurrent malignancy. The lesion demonstrated concerning features on CT, MRI, and PET-CT, prompting further evaluation with fine-needle aspiration and core needle biopsy, which revealed a granulomatous foreign-body reaction without evidence of malignancy. The patient was managed with observation, and surveillance imaging demonstrated stability without disease recurrence at 12 months. This case highlights an important diagnostic pitfall with significant implications for postoperative oncologic surveillance in head and neck surgery.

Aspiration is the unintentional passage of material from the oropharynx or gastrointestinal tract into the larynx, tracheobronchial tree, or lung parenchyma. Aspirated material may include saliva, oral secretions, food, liquids, gastric contents, bile, blood, or foreign material. Although small-volume aspiration may occur without clinically apparent disease, aspiration can cause airway obstruction, chemical pneumonitis, bacterial pneumonia, acute hypoxemic respiratory failure, acute respiratory distress syndrome, lung abscess, empyema, bronchiectasis, or chronic aspiration-related lung disease. Normal swallowing requires coordinated oral, pharyngeal, and esophageal phases. During the pharyngeal phase, elevation of the larynx, epiglottic inversion, vocal-fold closure, pharyngeal contraction, and an effective cough reflex help prevent material from entering the lower respiratory tract. Dysfunction at any stage may impair airway protection. Aspiration risk is therefore increased in patients with oropharyngeal dysphagia, neurologic disease, impaired consciousness, sedative exposure, neuromuscular weakness, structural head and neck disease, esophageal dysmotility, gastroesophageal reflux, vomiting, or delayed gastric emptying. Aspiration syndromes are classified according to aspirate composition, volume, bacterial burden, site of deposition, and temporal pattern. Macroaspiration refers to the inhalation of a clinically significant volume of material and may cause abrupt airway obstruction or acute lung injury. Microaspiration is often recurrent and clinically silent but may contribute to aspiration pneumonia or chronic airway injury in susceptible patients. Aspiration pneumonitis is an acute inflammatory lung injury caused by inhalation of noxious material, most often acidic gastric contents. In contrast, aspiration pneumonia is an infectious process that follows aspiration of colonized oropharyngeal secretions or gastrointestinal contents into the lower respiratory tract. These syndromes may overlap, particularly when partially digested gastric contents contain both acidic material and bacteria. The clinical course ranges from asymptomatic aspiration to rapidly progressive respiratory compromise. Chemical pneumonitis typically develops soon after a witnessed macroaspiration event, whereas aspiration pneumonia may develop more insidiously after unwitnessed or recurrent aspiration. Older adults and patients with frailty, stroke, dementia, Parkinson disease, critical illness, or impaired swallowing are disproportionately affected and may have recurrent events with substantial morbidity and mortality. Aspiration-related lung injury generally follows gravity-dependent bronchopulmonary segments. In patients who aspirate while upright, infiltrates commonly involve the basal lower-lobe segments. In recumbent patients, the posterior upper lobes and superior segments of the lower lobes are more often affected. The right lung is frequently involved because of the more vertical course of the right main bronchus, although bilateral or nondependent disease may occur depending on body position, aspirate volume, and underlying lung disease. Recognition of aspiration risk and early differentiation among airway obstruction, aspiration pneumonitis, and aspiration pneumonia are essential, as diagnostic evaluation, airway management, antimicrobial therapy, and preventive interventions should be individualized to the clinical setting and suspected aspirate.

Dental trauma is a recognized complication of airway management during general anesthesia, particularly in patients with poor dentition. Dislodged teeth pose a significant risk of airway obstruction, aspiration, and subsequent pulmonary complications, with important medico-legal implications. We report the case of a 45-year-old male with multiple loose and missing teeth, scheduled for an uncemented bipolar hemiarthroplasty under general anesthesia following a polytrauma incident one week prior. Despite appropriate preoperative counseling and informed consent, a dental injury occurred during direct laryngoscopy. An upper central incisor fractured and was immediately retrieved. Subsequently, an upper lateral incisor became dislodged and could not be located on the initial laryngoscopic examination or the intraoperative chest X-ray. Systematic reassessment, including thorough suctioning and repeat airway inspection, revealed the tooth lodged in the pyriform fossa, which was successfully retrieved using Magill's forceps. The patient remained hemodynamically stable throughout, with no evidence of aspiration or postoperative complications. Dental injuries during anesthesia are multifactorial and more common in patients with pre-existing dental pathology. This report highlights the importance of a meticulous preoperative dental assessment, clear risk communication, and thorough documentation. It also underscores the need for a structured, persistent approach to locating and retrieving dislodged teeth, as they may not always be detectable on radiographic imaging. Iatrogenic dental trauma during airway management can be effectively managed with prompt recognition, systematic evaluation, and timely retrieval. Preventive strategies, careful airway handling, and adherence to a structured retrieval protocol are essential to minimize complications and medico-legal risk.