Abstract
Introduction
 An extremely rare case of a pair of nails impacted in the right pyriform sinus, presenting 72 hours after the incident, is reported.
 Case Report
 X-ray soft tissue neck revealed the presence of a pair of nails in the neck at C4-C5 vertebral level. The foreign bodies could not be seen on hypopharyngoscopy due to severe mucosal oedema. Lateral pharyngotomy was done to remove the nails with C-arm guidance.
 Discussion
 Retained foreign bodies in the aerodigestive tract are known to produce complications. Delayed presentation makes the management difficult. C-arm guidance during surgical exploration is helpful to locate a radiopaue foreign body in difficult situations.
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