Cryoextraction: A novel approach to remove aspirated chewing gum
A 58-year-old woman presented to the emergency department after she awoke in the morning with cough. She went to sleep with a chewing gum in her mouth and when she awoke, the gum was no longer present. She reported sleeping many times with chewing gum in her mouth without any problems. She denied any other significant medical history and was a lifelong non-smoker. She denied dyspnea or fever, but reported some substernal chest discomfort and minimal blood tinged phlegm. Her presentation prompted the performance of a chest roentgenogram [] and computed axial chest tomogram []. The prior was unremarkable, but the latter confirmed the presence of a foreign body in the left proximal mainstem bronchus. The patient then underwent a flexible bronchoscopy through an endotracheal tube, with the use of a 5.2-mm Olympus Flexible Video Bronchoscope (Olympus America, Center Valley, PA, USA). A foreign body, identified as chewed gum, was noted in the proximal left mainstem bronchus. Repeated attempts to remove the gum with forceps and a basket were unsuccessful, with only small pieces being removed. We then decided to try to remove the gum with the use of the cryotherapy probe. The ERBE cryotherapy system (Erbokryo, ERBE Cryosurgery, Tübingen, Germany) was utilized, with a 1.9-mm cryotherapy probe. This allowed us to successfully remove en-bloc the entire chewing gum. The patient tolerated the procedure well and was discharged the next day with no complications, and with resolution of symptoms. Four weeks later during a routine follow-up, she reported no further problems.