A Case of a Fish Bone Foreign Body in the Tongue that was Removed by Intraoperative CT

Abstract

Fish bones can often get stuck in the tonsil or the root of the tongue, but rarely penetrate into the lingual tissue, and intraoperative identification of the location of the foreign body under general anesthesia can be quite difficult. In the present study, we experienced a case in which a fishbone penetrated into the tongue and was removed under general anesthesia by multiple needle punctures and intraoperative CT imaging.

A 73-year-old man ingested boiled fish at a drinking party and visited the otorhinolaryngology clinic seven days later because of persistent discomfort when swallowing. A CT scan showed a 1-centimetre linear hyperabsorptive area on the left side of the root of the tongue and a stuck fish bone was suspected. Intraoperative ultrasonography under general anaesthesia was used to confirm the location of the foreign body, but after the incision, it became difficult to identify the location. For survey, six needles were inserted into the tongue and intraoperative CT was performed. The fishbone foreign body was identified between the second and third needles posterior on the caudal side of the incision line. After removal of the other needles, the fish bone was identified and removed through a further incision in the lingual muscle layer using the needles as an indicator. We believe this approach is useful in cases in which intraoperative identification is difficult.