Foreign Body

Intraglossal impaction of ingested fish bones: A case series

July 31, 2010     Shirish Johari, BSc, MBBS, DLO, DOHNS(Edin.), MRCSEd; and Kevin Yaw-Khian Chong, MBBS, FRCS(Ed), M Med(ORL-Singapore), FAMS(ORL), FAAOHNS(USA), EAONO, AINO(Italy)
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Abstract

Although foreign body ingestion and impaction in the pharynx or hypopharynx are quite commonly encountered at our institution, foreign body impaction in tongue tissue is rare. Six cases of foreign bodies embedded in the tongue were identified in a retrospective review spanning the years 1998 to 2007. All the foreign bodies were fish bones. Four of these patients required only tongue exploration to remove the bone; one required a partial glossectomy because of difficulties locating the bone; and one required incision and drainage of an intraglossal abscess that had developed, as well as a tracheostomy. All foreign bodies were successfully removed, with none of the patients experiencing altered sensation or problems with tongue mobility afterwards.

Retained pill capsule remnant in pyriform sinus

April 30, 2010     Ellen L. Baxter, DO and Adam D. Rubin, MD
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An insect on the tympanic membrane

March 1, 2010     Arun K. Gadre, MD, FACS, DORL
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Nasal foreign body as the cause of a subperiosteal orbital abscess in a child

February 1, 2010     Benjamin D. Webb, MD, Kevin D. Pereira, MD, MS (ORL), and Samer Fakhri, MD, FACS, FRCS
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Abstract

We present what to the best of our knowledge is the first reported case of an orbital abscess as a result of acute rhinosinusitis caused by obstruction of the middle meatus secondary to the impaction of a nasal foreign body in a child. The patient, a 5-year-old Hispanic boy, had presented with left periorbital edema, eye pain, rhinorrhea, headache, and a fever. The presence of a nasal foreign body had been suggested by a finding of a low-density signal in the left anterior nasal cavity and middle meatus on computed tomography. Endoscopic drainage of the abscess through the involved sinuses revealed that the foreign body was a wad of cotton. The cotton was removed, and the patient recovered uneventfully.

Calcified maxillary cyst secondary to a foreign-body reaction at the site of a remote tooth extraction

January 1, 2010     Alexander Langerman, MD, Farhad Sigari, MS, MD, and Robert Naclerio, MD
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Abstract

Unilateral sinus disease has a wide differential diagnosis. When a patient has a history of maxillary dental work on the same side as the sinusitis, a foreign entity introduced during or subsequent to the dental manipulation must be considered. We present a case of calcified maxillary cyst that was discovered at the site of a remote tooth extraction. Pathologic analysis revealed the presence of vegetable matter within the cyst. To the best of our knowledge, no case of a maxillary cyst secondary to vegetable matter has been previously reported in the literature.

Bean sprout impaction in the pharynx: Two cases of this unusual foreign body

August 31, 2009     Dulani Mendis, DOHNS, MRCS and Simon Thorne, DLO, MRCSEd
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Abstract

We report 2 cases of bean sprout impaction in the pharynx. To the best of our knowledge, pharyngeal impaction of a bean sprout has not been previously described in the literature. We also comment on the theoretical infective risks associated with the long-term impaction of organic foreign bodies and the validity of a thorough ENT examination, even when the foreign body appears to be insignificant.

Foreign body in the pediatric airway

June 30, 2009     Yuri Gelfand, MD, Soham Roy, MD, FACS, FAAP, and James Albright, FACS, FAAP
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Dacryocystitis secondary to an iatrogenic foreign body in the lacrimal apparatus

June 30, 2009     Deepak Gupta, MS, FRCS, Heikki B. Whittet, FRCS, Salil Sood, MS, MRCS, and Suchir Maitra, MS
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Abstract

Dacryocystitis is an infection of the lacrimal sac that is usually caused by obstruction of the nasolacrimal duct. We describe a case of iatrogenic dacryocystitis that occurred secondary to the presence of an impacted piece of a metallic dilator in the lacrimal apparatus. The foreign body was detected on dacryocystography and removed during dacryocystorhinostomy. The patient recovered uneventfully.

Foreign body in the external auditory canal

June 30, 2009     Mary Burton, AuD and Arun K. Gadre, MD
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Three-dimensional computed tomography for detection and management of ingested foreign bodies

April 30, 2009     Rabia Shihada, MD, Moshe Goldsher, MD, Sliman Sbait, MD, and Michal Luntz, MD
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Cervical esophagotomy for an impacted denture: A case report

March 1, 2009     Sardar Zakariya Imam, MD, Mubasher Ikram, FCPS, Saulat Fatimi, MD, and Moghira Iqbal, FCPS
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Abstract

We present the case of a 46-year-old woman with an impacted denture and an impending esophageal perforation. Her family physician initially missed the diagnosis but during a subsequent visit reviewed her x-ray and was able to see the shadow of the denture's wire attachment in her esophagus. The patient was then referred to a tertiary care hospital, where esophagoscopy confirmed the location of the denture, but the surgeon there was unable to remove it. Eighteen days after she had swallowed her denture, she was referred to our hospital. Attempts at removal via rigid esophagoscopy were unsuccessful, but the denture was successfully removed via a cervical esophagotomy. A Gastrograffin swallow performed 1 week postsurgically showed no extravasation of the contrast medium, and subsequent follow-ups were unremarkable. We conclude that cervical esophagotomy is a safe method for removing foreign bodies impacted in the cervical esophagus when they cannot be removed endoscopically.

Formation of an airway foreign body during removal of a metal tracheostomy tube: A case report

March 1, 2008     Mitchell R. Gore, PhD and Austin S. Rose, MD
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Abstract

Tracheostomy tube changes are often performed in the clinic or at the bedside without complication. We report a case in which the removal of a long-term metal tube in a clinic setting was complicated by the presence of fibrinous debris on the tube. The debris had accumulated over a period of at least 3 years. The patient was taken to the operating room, and the tube was removed. However, the fibrinous debris remained behind, leaving an airway foreign body. The foreign body was subsequently removed with an optical foreign-body extraction forceps under direct visualization. Based on our experience and on the limited amount of information available in the literature, we recommend that long-term metal tracheostomy tubes be changed not in the clinic but in the operating room, where potential complications can be more easily managed.

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