# Right Under Your Nose! A Search for a Dislodged Tooth Discovered in the Nasopharynx by Lateral Neck Radiograph

## TL;DR

A dislodged tooth during surgery was found in the nasopharynx using a lateral neck radiograph, emphasizing its diagnostic value.

## Contribution

Demonstrates the utility of lateral neck x-rays in locating foreign bodies in the nasopharynx.

## Key findings

- Standard x-rays failed to locate the dislodged tooth, but a lateral neck radiograph identified it in the nasopharynx.
- A nasopharyngeal airway enabled successful removal of the tooth.
- Lateral neck x-rays are effective for detecting foreign bodies in supine patients.

## Abstract

During nasotracheal intubation for mandibular fixation surgery in an 85-year-old man, a loose tooth was inadvertently dislodged and remained undetected despite repeated laryngoscopic and bronchoscopic exploration. Antero-posterior chest, abdominal, and neck x-rays also failed to locate the tooth. A lateral neck radiograph was then obtained, which revealed the tooth in the nasopharynx. A nasopharyngeal airway was inserted, enabling the tooth to be successfully displaced caudally and extracted. This case highlights the value of lateral neck x-rays in identifying foreign bodies, especially in supine patients where objects may fall posteriorly and cephalad into the nasopharynx.