Nasopharynx- The Secret Vault for Lost Foreign Bodies of the Upper Aerodigestive Tract

Document Type: Case Report

Authors

1 Department of Otorhinolaryngology and Head-Neck Surgery; ICARE Institute of Medical Education and Research. Banbishnupur West Bengal, India.

2 Department of Otorhinolaryngology and Head-Neck Surgery, Medical College and Hospital, Kolkata 88, College Street, Kolkata – 700073, West Bengal, India.

Abstract

Introduction:
Foreign bodies in the upper aerodigestive tract often get lost following inappropriate attempts at removal. Children may present late with localized infection, posing a challenge to the otolaryngologists in a referral set-up in diagnosing and retrieving such foreign bodies.
 
Case Report:
A two-year-old boy presented with refractory purulent rhinorrhea and intermittent low-grade fever. The symptoms suggested rhinosinusitis; however, following a high index of suspicion, he was referred for further evaluation, with the possibility of any hidden foreign object in the upper aerodigestive tract. His soft palate appeared bulged, and his mother informed that he had ingested the cap of a plastic bottle about a month back which could not be retrieved despite several attempts by her. X-ray of soft tissue nasopharynx revealed a radiolucent shadow of a round object resulting in palatal bulging. It was eventually removed by combined endoscopic/transoral approach.
 
Conclusion:
In a child with a lost foreign body, the nasopharynx should be meticulously explored. This is less common for ingested objects compared to inhaled ones. The diagnosis becomes furthermore challenging when it is not radio-opaque. Naïve manipulations must be avoided and prompt referral should be made to the otolaryngologists for guided removal and minimizing complications.

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Main Subjects

References

1. Dutta M, Ghatak S, Biswas G. Chronic discharging ear in a child: are we missing something? Med J Malaysia 2013;68(4): 368-71.

2. MacNeil SD, Moxham JP, Kozak FK. Paediatric aerodigestive foreign bodies: remember the nasopharynx. J Laryngol Otol 2010; 124(10): 1132-5.

3. Jotdar A, Dutta M, Mukhopadhyay S. Nasal Foreign Body, Dislodged and Lost- Can the Adenoids Help? J Clin Diag Res 2015; 9(6): MD06-7.

4. JKAG Sunkum. Nasopharyngeal foreign body in an young child. Indian J Otolaryngol Head Neck Surg 2011; 63(3):285-6.

5. Ray L, Chatterjee P, Bandyopadhyay SN, Das S, Sinha R, Nandy TK. An unusual foreign body (Big Metallic Nut) in the nasopharynx of an infant. Indian J Otolaryngol Head Neck Surg 2004; 56(4): 309-10.

6. Ogut F, Bereketoglu M, Bilgen C, Totan S. A metal ring that had been lodged in a child's nasopharynx for 4 years. Ear Nose Throat J 2001; 80: 520-2.

7. Oysu C, Yilmaz HB, Sahin AA, Külekçi M. Marble impaction in the nasopharynx following oral ingestion. Eur Arch Otorhinolaryngol 2003; 260(9):  522-23.

Iranian Journal of Otorhinolaryngology

Volume 28, Issue 6 - Serial Number 89
November and December 2016
Pages 431-434

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