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Foreign bodies in otorhinolaryngology: bones, thorns and piles

A brief review of foreign bodies in the field of otorhinolaryngology has already been made above. However, fish bones and embedded bones deserve a separate chapter

  • Patients frequently come to the emergency department because they have been stuck with a fish bone. They are usually located at the level of the palatine tonsils, easily visible by opening the mouth, or at the base of the tongue (lingual tonsil), which is more difficult to see. For this we have to resort to vision with rigid endoscope or with fiberscope (flexible) and some special forceps to reach that level; sometimes it is necessary to apply a little local anesthesia to be able to extract them.many patients report having eaten bread crumbs to try to get the thorn out. I do not recommend it, because what usually happens is that the spine can break and, even if it is stuck, as it does not stick out, we cannot remove it.
  • Bones should be mentioned separately, as they are not flexible like the thorns and can perforate the esophagus. If we do not see them with the endoscopic exploration at the hypopharynx level, they could be in the esophagus and for this we resort to requesting an X-ray. If they are at this level and we cannot access them, we request the intervention of another specialist, digestive system, to be able to extract them; this would already be under general anesthesia or sedation.
  • Button batteries are very dangerous and children can remove them by manipulating a toy and swallowing them. In case of suspicion, the patient should be taken immediately to a hospital to remove the battery as soon as possible, because in contact with the esophageal mucosa it can cause perforation and poor healing, causing flanges and stenosis (narrowing or even closure) of the lumen (inner space) of the esophagus and making feeding difficult in the long run.