Fish Bone Foreign Body Research Articles

A case of migratory fish bone in the thyroid gland

Fish-bone foreign bodies represent a common condition readily identified in the pharynx. We encountered a case of fish bone in the thyroid gland. Only three other such cases have been reported in the English-language literature. This foreign body was identified by computed tomography and ultrasonography 16 days after onset, and removed through a cervical skin incision. The diagnosis and treatment of extrapharyngeal foreign bodies are discussed.

椎前筋膜内に埋没した魚骨異物例

We described a rare case of fish bone foreign body which pierced the pharynx and stuck in the deep cervical fascia.A 62-year-old male suffered from a sore throat after he swallowed fish, and a foreign body in the pharynx was suggested. Under routine fiberscopic examination, however, no fish bone was detected, so the patient was prescribed antibiotics, and sore throat disappeared. Because swelling of the pharynx persisted for six days, CT examination was carried out and the foreign body was found at the posterior part of the pharynx.By extra-cervical incision, the foreign body was found penetrating the retropharyngeal space, stuck in the deep cervical fascia.

Use of plain radiography and computed tomography to identify fish bone foreign bodies

Introduction: Fish bones are the most common aerodigestive foreign bodies in adults. Radiographic studies, often ordered for diagnosis, have questionable utility. Methods: With a laryngoscope, bones from 10 fish species were placed in a variety of positions in a human head and neck cadaver specimen. Plain films and CT scans were obtained and evaluated by blinded readers. Results: Plain radiography exhibited a sensitivity and specificity of 39% and 72%. Cooking did not grossly change radio-opacity. The species of fish affected visibility in soft tissue, without correlation to the characteristic optical density of each species. Bones placed orthogonal to the film in the vallecula were most readily identified. CT scanning correctly identified 9 of 10 bones. Conclusions: Plain radiography poorly visualizes fish bone foreign bodies in soft tissue; visibility varied with fish species, location, and orientation. CT is the test of choice to radiographically diagnose fish bone impactions. (Otolaryngol Head Neck Surg 2000;123:435-8.)

Use of plain radiography and computed tomography to identify fish bone foreign bodies

Use of plain radiography and computed tomography to identify fish bone foreign bodies

魚骨異物におけるＣＴの診断的有用性

Fish bone foreign bodies impacted in the aerodigestive tract are a common ENT emergency. In most cases, fish bones are impacted within the oral cavity or oropharynx and easily identified and removed. But in some cases, they are impacted more caudally or deeply into the mucosa and diagnoses based on inspection alone are impossible. In such cases, radiological investigations are needed.Plain-film radiology is used frequently, but it is not very sensitive and cannot show the inflammatory changes around the fish bone. We show the efficiency of computed tomography (CT) scanning in diagnosing fish bones in the aerodigestive tract, and propose the use of CT scanning for screening in cases of fish bone impaction with prolonged pain or dysphagia.

内視鏡処置後に気腫を生じた食道魚骨異物の１例

A 70-year-old woman was admitted to our hospital because of a cervical esophageal perforation caused by a flexible fiberscope. After an esophageal fish-bone foreign body was removed by a flexible fiberscope, the patient's cheek, neck and anterior chest wall started swelling. Chest X-ray and computed tomography revealed mediastinal and subcutaneous emphysema. Dyspnea was not observed, oral intake was withheld, and antibiotics were administered. Surgery was not attempted, since no symptoms were observed within 72 hours after the injury. Four days after admission, a fluoroscopic X-ray examination of the neck, thorax and esophagus was performed. Oral intake was restarted on the fifth day, and the patient was discharged on the tenth day.

A multi-observer study examining the radiographic visibility of fishbone foreign bodies.

The use of plain radiographs to localize a suspected fishbone foreign body is the subject of controversy. Accordingly radiographs of 14 species of fishbone, impacted in a soft tissue phantom, were assessed by a series of observers from the ENT department (consultant surgeons, senior registrars and house officers). The agreement was assessed by graphical description of the data and tested by a Spearman's rank correlation test. The overall results showed that, for the clinician, radiography is very useful to detect the bones of: cod, haddock, lemon sole, cole fish, grey mullet and plaice; useful for red snapper, monk fish, gurnard and salmon; and unhelpful in detecting bones from herring, pike, mackerel and trout. The use of radiographs to locate these impacted fishbones can be rationalized in the light of these findings.

魚骨異物の２症例 咽頭および食道腔外異物

Two cases of fish-bone foreign body were reported. Case 1 was a 75-year-old female who suffered from cervical pains after eating bonito. No foreign bodies were found by indirect laryngoscopical nor esophagoscopical examination. The foreign body was found embedded in the posterior wall of the pharyx on X-ray and CT scan. Case 2 was a 77-year-old female who had pains after eating bonito. Neither indirect laryngoscopical nor esophagoscopical examination revealed any foreign bodies in the pharyngoesophageal space. X-ray and CT scan revealed an extra-esophageal foreign body with a surrounding periesophageal abscess and cervical subcutaneous emphysema. By an extra cervical incision, the foreign body was found penetrating the esophagus and reaching carotid artery. These two cases suggest the importance of conducting X-rays and CT scans even if no foreign bodies are found under laryngo-esophagoscopical examination.

声帯麻ひをきたした下咽頭魚骨異物症例

A rare case of a hypopharyngeal foreign body (a fish bone) as long as 4cm accompanied by vocal cord paralysis is reported. A 70-year-old man visited our clinic suffering from dysphagia, swallowing pain and hoarseness. He had eaten “Namabushi” two days before his visit, which is a Japanese dish consisting of half-dried steamed bonito. Left vocal cord paralysis and edema in the left piriform sinus and the arytenoid region were observed, but we could find no foreign body using a laryngeal fiberscope. Roentgenograms and laminagrams revealed a linear, fish bone-like shadow located from the inferior edge of the thyroid cartilage to the left lateral neck area. The fish bone foreign body was removed under general anesthesia. The skin incision was developed on the left lateral neck. The fish bone had entered between the cricoid and thyroid cartilages just 2-3mm medial from the left inferior cornu and had also pierced the sterothyroid and sternohyoid muscles. Its end extended to the subcutaneous region of the neck. Vocal cord paralysis still remained on the 20th postoperative day but had disappeared on the 30th.

Radiology of fish bone foreign bodies in the neck

Radiology of fish bone foreign bodies in the neck

Application of Xeroradiography to Fish Bone Foreign Bodies in the Esophagus

Application of Xeroradiography to Fish Bone Foreign Bodies in the Esophagus