Images of Common Foreign Body at an Uncommon Site

Abstract

A 73-year-old male resident of Wardha presented to the Ear, Nose and Throat (ENT) Outpatient Department (OPD) with complaints of a foreign body sensation in his throat for the past eight days. He described ingesting a fish bone a week earlier and experiencing mild throat soreness. Subsequently, it developed into a persistent foreign body sensation in the throat and difficulty in deglutition, which did not subside with the intake of antacids and other throat lubricants. There was no history of fever following this incident. The posterior pharyngeal wall was found to be clear during the throat examination. Indirect laryngoscopy revealed that all hypopharyngeal structures were normal. However, during video [Video-1] direct laryngoscopy, a fish bone was discovered embedded in the lingual surface of the epiglottis (Table/Fig 1). Upon receiving written consent, the embedded fish bone was removed with the help of long artery forceps under the guidance of video direct laryngoscopy (Table/Fig 2). There was no evidence of bleeding, oedema, or congestion after the procedure. The foreign body measured approximately 1.5 cm and was causing the patient immense discomfort (Table/Fig 3). The patient was prescribed a five-day course of antibiotics after the procedure, which included Tablet Amoxyclav 625 mg BD (Amoxicillin plus Clavulanic acid), Tablet Zerodol SP BD (Aceclofenac / Paracetamol / Serratiopeptidase), Tablet Pantop 40 mg OD (Pantoprazole), Tablet Levocet 10 mg HS (Levocetirizine), Syrup Mucaine gel 2 tsp BD (Aluminium hydroxide, magnesium hydroxide, and oxetacaine), and Betadine gargle TDS. He was advised to follow-up after five days to check for any delayed onset of postprocedure complications.

Keywords

• dysphagia
• fish bone
• throat