Case presentation
Case 1: migratory fish bone in the retropharyngeal space.
A 62-year-old male patient had suffered from sudden onset pharyngeal pain after he had fish. He visited the local hospital. Fiberoptic laryngoscopy showed that no abnormalities were detected. CT revealed a foreign body lying transversely at the right piriform fossa. Subsequently, painless gastroscopy was performed in order to remove foreign body. Unfortunately, no foreign body was detected. Laryngeal edema occurred during painless gastroscopy, tracheal intubation was performed.
The patient was referred to our hospital after 4 days. After admission, cervical CT was repeated. CT showed that a foreign body was observed in the right retropharyngeal space. The foreign body was observed between cervical vertebra 1 and 2 (Figure 1A, B). Subsequently, he underwent an exploration of the retropharyngeal space and removal of the foreign body under general anesthesia. During the operation. Foreign body cannot be detected in the plane of the second cervical vertebra. Prolonged the longitudinal incision was performed to find the fish bone in the surrounding tissues. Finally, the foreign body was found in the plane of the third cervical vertebra, which was a fish bone. After 1 week of follow-up the patient showed no symptoms of pain or foreign body sensation.
Case 2: migratory fish bone in the hypopharynx.
A 52-year-old man was admitted to our department with throat pain, foreign body sensation, dysphagia, and mild sialorrhea for 3 days after eating a meal of fish. Cervical CT confirmed the presence of a linear radiopaque structure in the left laryngopharynx (Figure 2A, B). Flexible fiberoptic laryngoscopy could not identify a foreign body (Figure 2C). No mucosal lesion was observed. Gastroscope examination were performed to further ascertain whether there was a foreign body in the hypopharynx. A fish bone was seen in the left piriform fossa (Figure 2D). The fish bone pierced from the left piriform fossa into the posterior pharyngeal wall. The object was grabbed with foreign body forceps. After the examination, the patient immediately felt comfortable.