Subjective neck pain or foreign body sensation and the true location of foreign bodies in the pharynx

Abstract

Conclusion: The location of the foreign body did not correspond well to the location of pain reported by patients. When patients present with foreign bodies in the pharynx, in addition to recording the location of pain and foreign body sensation, clinicians should perform a comprehensive and thorough oropharyngeal examination to avoid misdiagnosis. Objectives: Physicians are often guided by patient-indicated locations of pharyngeal foreign bodies. In this study, we aimed to determine the correlation between the location of the subjective neck pain or foreign body sensation and the true location of the foreign body. Methods: We prospectively studied 90 patients who had pharyngeal foreign bodies removed at MacKay Memorial Hospital. We divided the head and neck into 10 zones according to the superficial anatomy. Subjective location, examination findings, and actual foreign body location were recorded and compared. Results: The overall subjective and true locations of the foreign body were poorly correlated (kappa 0.27, p = 0.003). The positive predictive value (PPV) for the midline neck was 68%, which was higher than that on either lateral side of the neck. PPV above cricoid cartilage level was 66%.