Foreign body aspiration occurs most commonly in children and can have serio
us consequences. In adults, it is associated with surgery, trauma and accid
ents. We report four unusual cases of foreign body inhalation. In one case
a spike of wild barley entered the trachea through a tracheostomy cannula a
nd migrated from the chest wall. In the second case a piece of coarse cloth
which was introduced through a tracheostomy stoma aided by a wood sliver w
as retained in the trachea. In another patient an inhaled sewing needle mig
rated to the pericardium, and in the fourth case the head of a metal stud p
enetrated the trachea percutaneously through the neck and lodged in the rig
ht main bronchus. The incidence, causes, complications and management of su
ch cases are discussed and the literature is briefly reviewed.