A Case Report of Removal of an Extrapharyngeal Fishbone Foreign Body via a Skin Incision on the Neck

Abstract

Ingested foreign bodies are not rare occurrences in daily clinical practice and it is said that about 90% of foreign bodies are fishbones. Herein, we report a case of an ingested fishbone that migrated to the extrapharyngeal space and had to be removed through a skin incision on the neck. A 69-year-old woman who had eaten sea bream the previous day visited a doctor complaining of discomfort swallowing. At the initial examination, there are no significant findings and a fishbone could not be identified. However, upon re-examination three days later, we noticed mild swelling in the posterior pharyngeal wall using a laryngeal fiberscope. A CT examination revealed a fishbone foreign body in the posterior pharyngeal wall. We then removed the fishbone from the inferior pharyngeal constrictor muscle through a skin incision on the neck. The long axis of the extracted fishbone was 23 mm.

After the surgery, the patient recovered with the administration of antibiotics and nutritional management through a nasogastric tube. In this case, a fishbone migrated to the extrapharyngeal space through a rare route of insertion. It is likely for this reason that no significant findings were observed at the initial examination. Even in cases there are no significant findings, if it is suspected that a foreign body has migrated to the extrapharyngeal space, a proactive CT examination is necessary.