Abstract
BackgroundFish bones are common foreign bodies in the upper aero-digestive tract, but their clinical features in relation to fish species have not been confirmed. We aimed to clarify the clinical characteristics of fish-bone foreign bodies and their location and removal methods depending on the fish species.Study designRetrospective, observational, monocentric study.MethodsFrom October 2015 to May 2020, 368 patients visited the Department of Otolaryngology-Head and Neck Surgery at Tohoku University Hospital complaining of dysphagia, sore throat, or pharyngeal discomfort after eating fish. We analyzed the patients’ sex and age distribution, foreign-body location, type of the fish, and the techniques used for removing the foreign body.ResultsFish bones were confirmed in the upper aero-digestive tract in 270 cases (73.4%), of which 236 (87.4%) involved fish-bone foreign bodies in the mesopharynx. The most frequently involved site was the palatine tonsil (n = 170). Eel was the most frequently observed fish species (n = 39), followed by mackerel (n = 33), salmon (n = 33), horse mackerel (n = 30), and flounder (n = 30). Among the 240 cases in which the bones did not spontaneously dislocate, 109 (45.4%) were treated by endoscopic removal (103 cases) or surgery (6 cases). In pediatric cases (<12 years old), almost all fish bones were found in the mesopharynx (138/139, 99.3%), and 31 cases (22.3%) required endoscopic removal. Flounder fish bones were often lodged in the hypopharynx and esophagus (9/30, 30%), hindering spontaneous dislocation and frequently necessitating endoscopic or surgical removal (19/29, 65.5%).ConclusionThe characteristics of fish-bone foreign bodies differed depending on the fish species. Flounder bones were often stuck in the hypopharynx and esophagus and were likely to require more invasive removal methods. Confirming the species of the fish could facilitate appropriate diagnosis and treatment of fish-bone foreign bodies.
Highlights
Fish bones in the upper aero-digestive tract are a common presentation in the emergency department and in otolaryngology clinics, especially in countries with high rates of fish consumption, such as Asian, Mediterranean, and other coastal countries [1,2,3,4]
We retrospectively investigated the clinical characteristics of fish-bone foreign body patients and analyzed the differences in the predilection sites and removal methods among various fish species
Fish bone impaction was observed on the right side, left side, and the middle in 122, 115, and 14 cases, respectively, and the side of impaction was unknown in 19 cases
Summary
Fish bones in the upper aero-digestive tract are a common presentation in the emergency department and in otolaryngology clinics, especially in countries with high rates of fish consumption, such as Asian, Mediterranean, and other coastal countries [1,2,3,4]. The age distribution of fish-bone foreign bodies varies, and children, especially those aged 2–4 years, and middle-aged adults show the highest prevalence [1, 2, 11]. The common impaction sites of fish bones include the palatine tonsils, lingual tonsils, vallecula of the epiglottis, and pyriform sinus. Appropriate diagnosis and prompt treatment are required to manage fish-bone foreign bodies in the upper aero-digestive tract. Fish bones are common foreign bodies in the upper aero-digestive tract, but their clinical features in relation to fish species have not been confirmed. We aimed to clarify the clinical characteristics of fish-bone foreign bodies and their location and removal methods depending on the fish species
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
