Abstract
BackgroundForeign body inclusions are rare in head and neck. They are challenging in regard to anatomical risks and surgical approaches. This is the case of a particular foreign body with a curious trajectory, associated with a brief review of anatomical risks and surgical approaches.Case presentationThis is the case of a 25-year-old male who has been attacked with a sharp object, which caused an inclusion of a part of the foreign body in the sub-mental and pharyngeal areas.The clinical exam showed a painful bulging in the sub-mental area, with moderately hemorrhagic sputum and difficulty while swallowing. The intra-oral exam showed a foreign body that was located at the right side of the base of the tongue, and which goes backwards and outwards to penetrate retro-pharyngeal mucosa.The patients underwent an angio-CT scan, which showed a curious fine and sharp metallic object, without direct signs of lesions to the jugular vein or carotid artery or any collateral branches.The patient underwent extraction through cervical approach, with satisfying bleeding control. Intra-oral exploration showed a retro-pharyngeal lesion of 2 cm, without particular bleeding. The cervical lesion and retro-pharyngeal lesions were closed. The lesion at the base of the tongue was of 1 cm, palpable but not accessible to sutures, and a naso-pharyngeal tube was inserted.The patient presented very satisfying post-operative outcome, without any complications.ConclusionWhen dealing with foreign bodies of head and neck, physicians must be precocious and prepared for the risk of bleeding after extraction. Thorough radiological exploration is necessary as long as the patient is stable. Direct and indirect radiological signs allow the clinician to understand the nature and the trajectory of the object, as well as the damage to collateral structures.
Highlights
Foreign body inclusions are rare in head and neck
This is a rare case of a penetrating neck wound with a curious foreign body inclusion
The case presentation is associated with a review of the Cherrabi et al The Egyptian Journal of Otolaryngology (2021) 37:120 classification of neck injuries, a review of different surgical approaches depending on the nature of the lesions, and a discussion of radiological tools
Summary
When dealing with foreign bodies of head and neck, physicians must be precocious and prepared for the risk of bleeding after extraction.
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