Management of Adult Subglottic Foreign Body: A Case Report

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Objectives: To describe a rare case of delayed diagnosis of a subglottic foreign body (FB) in an adult, resulting in subglottic stenosis, and to evaluate the effectiveness of Suspension Microlaryngoscopy (SML) as a minimally invasive technique for its management. Case presentation: An adult patient presented with persistent respiratory symptoms and was ultimately diagnosed with a retained subglottic FB after a delayed clinical course. The FB was managed using endotracheal intubation and SML, which allowed precise visualization and extraction. Associated granulation tissue and mucosal overgrowth were treated with targeted resection and controlled cauterization. Discussion: The delayed presentation and nonspecific clinical manifestations posed significant diagnostic challenges, contributing to the persistence of the FB and the development of subglottic stenosis. SML provided excellent exposure of the subglottic region, enabling safe FB removal while minimizing trauma to surrounding tissues. Postoperative follow-up demonstrated complete symptom resolution and restoration of airway patency without complications. Conclusions: Subglottic FB impaction is an exceptionally rare condition in adults and may be overlooked because of its nonspecific presentation, leading to delayed diagnosis and airway complications. This case highlights the importance of maintaining a high index of suspicion for retained airway FBs in patients with persistent respiratory symptoms or unexplained subglottic stenosis. SML represents a safe and effective therapeutic option, offering precise visualization, atraumatic FB extraction, and successful management of associated granulation tissue, with favorable clinical outcomes.

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