A Curved Rigid Laryngoscope for Foreign Body Removal in the Pharynx and Esophagus

Abstract

Recently, there have been case reports on the usefulness of transoral removal procedures with a curved rigid laryngoscope for foreign body removal from the pharynx and esophagus. However, no case series have yet been performed on this topic. We treated four patients using this device in the last four years. This study aimed to investigate the clinical features of our cases and previously reported cases. In addition, we showed one representative case of fish bone swallowing into the hypopharynx. A 63-year-old woman presented with a complaint of pharyngeal discomfort after eating fish of the species Seriola quinqueradiata (Japanese amberjack). A fish bone was lodged between the bilateral piriform sinuses, and both its ends were penetrating the mucous membrane. We divided this fish bone at the center, and removed the two pieces with no further damage to the mucous membrane. To date, there have been 6 reports (7 cases) of foreign body removal from the pharynx and esophagus utilizing this technique. We investigated the clinical features of 11 cases including ours. The average age of the patients was 72.5 years old. The most common foreign body was a fish bone. Almost all foreign bodies were located between the hypopharynx and cervical esophagus. Unlike other devices used for removal purposes, a curved rigid laryngoscope enables a wide surgical view, thus providing a wide operating field and workspace. In all our cases, and in previously reported cases also, it was possible to easily divide the foreign body and apply traction or incise the mucous membrane surrounding it. Thus, we believe transoral foreign body removal with a curved rigid laryngoscope is a useful technique in cases of hypopharyngeal and cervical esophageal foreign bodies.