2020 Volume 29 Issue 3 Pages 355-359
Pharyngeal foreign bodies, mostly fish bones, are a common occurrence. These bones are usually located at the tonsils or the base of the tongue and are easily removed. However, foreign bodies are sometimes embedded in the submucosa and cannot be identified by fiberscope, making them difficult to remove. Here we report a case of an extra-pharyngeal foreign body that we could safely remove utilizing intraoperative X-ray radioscopy. The case was a 74-year-old man who had a sore throat and pharyngeal discomfort just after eating a dried fish two weeks before admission to our hospital. The foreign body was suspected to be embedded in the submucosa of the pharynx, because we could not find it in the pharynx with a fiberscope or even CT scan; X-ray examination of the neck clearly showed the foreign body in the pharynx and no sign of deep neck abscess. The CT scan was performed again on the 6th day after admission as the patient felt movement of the location of discomfort. The foreign body still remained and its position and shape were changed upward and curved. After taking aspirin for 7 days, we aimed to remove the submucosal embedded foreign body. The pharyngeal lumen was widely broadened by inserting a Sato-type curved laryngoscope transorally and X-ray radioscopy was used to detect the precise location of the embedded foreign body. The foreign body was extracted safely without bleeding, and was a thin wire that had likely strayed into the dried fish during the production process. We showed that intraoperative X-ray radioscopy was very useful for safely removing the submucosal embedded foreign body that could be detected by X-ray.
