Laryngectomized patients use a variety of tools for tracheostomy cleaning, some of which may vary greatly depending on their sociocultural status. The use of inappropriate tools may lead to complications. A seventy-eight-year-old male patient who had a history of total laryngectomy 12 years ago presented with difficulty in breathing and sputum production. Tracheoscopy showed two nails and chest x-rays showed one nail that had been aspirated during stromal care. The three ordinary nails were removed under general anesthesia. This case illustrates the need for detailed and consistent education of laryngectomy patients on proper stomal cleaning and on the associated complications that may arise from the use of inappropriate tools.
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