We report a case of delayed and unusual presentation of impacted laryngeal foreign body in a 35 year old man presenting with unremitting hoarseness for 3 months. [casereports.in]

We present a rare case of foreign body of larynx which was managed successfully. [jemds.com]

Two adult patients of foreign body larynx who presented to us with a short history of foreign body inhalation with severe respiratory distress are being reported. [ncbi.nlm.nih.gov]

• Foreign Body Aspiration

  Occult bronchial foreign body aspiration in adults: analysis of four cases. Respirology. 2004; 9 (4): 561-3[ DOI ][ PubMed ] 2. Ben-Dov I, Aelony Y. Foreign body aspiration in the adult: an occult cause of chronic pulmonary symptoms. [traumamon.com]

  On rare occasion, hoarseness may be the sole symptom of foreign body aspiration as also seen in our case [ 6 ]. Diagnostic imaging is vital in case of foreign body aspiration. [casereports.in]

  Describe the possible radiographic manifestations of foreign body aspiration. Explain the management of foreign body aspiration in children. Delineate the potential late complications of foreign body aspiration. [pedsinreview.aappublications.org]

  Complications arising from foreign body aspiration depend on the location and type of foreign body aspirated (organic vs. non-organic, sharp vs. dull), and the duration of time the foreign body remained in the airways. [hawaii.edu]

  […] of foreign body aspiration. [emedicine.medscape.com]

• Pain

  Bottom line: If a patient feels pain or the foreign body every time they swallow, it is probably still stuck, regardless of negative imaging. [entsho.com]

  […] body location Anterior jaw pain (pharynx) Neck Pain (cervical esophagus below cricopharyngeous) Chest Pain (thoracic esophagus) Initial Associated Symptoms or signs (may be asymptomatic) Cough Wheezing or Stridor Choking Dysphagia Dysphonia Chronic Symptoms [fpnotebook.com]

  What not to do: Do not assume that a foreign body is absent just because the pain disappears after swallowing local anesthetic. Do not reassure the patient that you have ruled out an foreign body if you have not. [ncemi.org]

  Management Frontiers in Medicine Epidemics Zika Virus Ebola Virus View all topics Health Policy Epidemics Pain Management Ebola Virus Multimedia Multimedia Selected Multimedia View all multimedia Audio Clinical Practice Audio Interviews Interactive Medical [nejm.org]

• Fever

  According to the mother, the symptoms had appeared 2 months ago and were initially accompanied by fever and productive cough, when the child was treated for 1 month in another hospital for community-acquired pneumonia, with partial clinical response. [thieme-connect.com]

  Fever. .. .. b. Polyphonic wheezing. .. .. c. Cough. .. .. d. Stridor. .. .. e. Monophonic wheezing 8. What physical exam sign/symptom is most worrisome in terms of degree of airway compromise?. .. .. a. Fever. .. .. b. Polyphonic wheezing. .. .. c. [hawaii.edu]

  Vague symptoms, such as abdominal distension and discomfort, fever, recurrent vomiting, passing rectal blood/melaena and/or other symptoms of acute or subacute intestinal obstruction, may be present. [patient.info]

  Symptoms may include persistent wheeze, cough, fever or dyspnoea not otherwise explained. Recurrent or persistent pneumonia may be the presenting feature. The child may be asymptomatic after the initial event. [rch.org.au]

  In this setting, it is not uncommon to treat patients for secondary complications, such as persistent fever, “asthma,” or recurrent pneumonia for long periods. [consultant360.com]

• Collapse

  Look for: an opaque foreign body segmental or lobar collapse localised emphysema in expiration (ball valve obstruction) The CXR may be normal. Management DO NOT perform the above manoeuvres. [rch.org.au]

  […] maintain airway Provide Supplemental Oxygen Keep patient as calm as possible and allow them to assume a comfortable position Do not perform back blows or blind finger sweeps (may completely obstruct airway) Avoid paralysis for Laryngoscopy as trachea may collapse [fpnotebook.com]

  […] complications such as mucosal ulceration, esophageal obstruction, perforation, intrinsic stenosis and esophageal diverticulum [ 12 ], whereas foreign bodies retention in the airway may lead to complications such as severe respiratory distress, lung collapse [bmcearnosethroatdisord.biomedcentral.com]

  The atelectasia originates from occlusion of the bronchus by the FB, the oedema and/or granulation tissue, which impedes the entry and exit of air, oxygen to the alveoli is reabsorbed and the section involved loses volume, retracts and collapses. [elsevier.es]

• Dentist

  The dentist is obligated to limit the extent of damages; therefore, whenever an incident occurs, the dentist must immediately initiate all necessary measures to avert further damages; otherwise, the dentist can be charged with negligence. [med-college.hu]

• Cough

  In most cases of inhaled foreign body, there is a definite history of choking followed by paroxysmal coughing. After the initial paroxysm of coughing the tracheobronchial mucosa becomes tolerant of the foreign body and coughing ceases. [jiom.com.np]

  Introduction Laryngeal impaction of foreign bodies are very rare as most aspirated foreign bodies passes through the laryngeal inlet and get lodged lower down in the airway or is coughed out by cough reflex. [casereports.in]

  When a FB tries to enter the larynx through glottis, spasm and severe cough expels it to supra glottis and if cough is forceful FB expels out of larynx and if cough is weak because of alcohol intoxication it may be held up in the vestibule of the larynx [jemds.com]

  If coughing is forceful, it may be expelled out of the larynx. [waent.org]

  Cough. .. .. d. Stridor. .. .. e. Monophonic wheezing 8. What physical exam sign/symptom is most worrisome in terms of degree of airway compromise?. .. .. a. Fever. .. .. b. Polyphonic wheezing. .. .. c. Cough. .. .. d. Stridor. .. .. e. [hawaii.edu]

• Stridor

  They presented with severe attacks of inspiratory stridor, difficulty in breathing and spitting blood. Indirect laryngoscopy revealed a dark greenish living foreign body in the larynx in each case. [ncbi.nlm.nih.gov]

  Resumed Report: An 11-month-old female patient (M.F.S.) presented to a tertiary hospital with severe dyspnea and stridor. [thieme-connect.com]

  The foreign bodies accidentally entering the larynx are symptomatic in the form of choking, stridor or even death. We are presenting a rare case of foreign body in the larynx in a 42 year old male who was symptom free except for dysphonia. [jemds.com]

  Symptoms may include: Choking or gagging when the object is first inhaled Coughing Stridor Wheezing (a whistling sound, usually made when the child breathes out) Although the initial symptoms listed above may subside, the foreign body may still be lodged [stanfordchildrens.org]

  Stridor. .. .. e. Monophonic wheezing 8. What physical exam sign/symptom is most worrisome in terms of degree of airway compromise?. .. .. a. Fever. .. .. b. Polyphonic wheezing. .. .. c. Cough. .. .. d. Stridor. .. .. e. Monophonic wheezing 9. [hawaii.edu]

• Hoarseness

  This 47-year-old female noted hoarseness that started 5-7 years before I saw her. The hoarseness has become progressively worse over the past 2 years. During the past 2 years, she has noted breaks in her voice and an increased effort to make sound. [voicedoctor.net]

  We report a case of delayed and unusual presentation of impacted laryngeal foreign body in a 35 year old man presenting with unremitting hoarseness for 3 months. [casereports.in]

  Teaching Hospital with a complaint of breathing difficulty and hoarseness for one month on 8/9/95. Emergency tracheostomy and direct laryngoscopy and biopsy were done. [jiom.com.np]

  Case Report: An 18 year old girl from the countryside presented with hoarseness of 3 hours duration. When she went to the fields to collect fodder for cattle she accidently inhaled some object during inspiration. [waent.org]

  Case 2 A 42-year-old man presented with accidental inhalation of a crepe bandage holding a metallic pin, followed by hoarseness and foreign body sensation in the throat with mild difficulty in breathing. [journals.lww.com]

• Dyspnea

  Diop et al. [2] were found in 83.07% of cases dyspnea and dysphonia in the remaining cases. The case dysphonia without dyspnea can be explained by the presence of a foreign body windowed allowing the ventilation airways. [scirp.org]

  Resumed Report: An 11-month-old female patient (M.F.S.) presented to a tertiary hospital with severe dyspnea and stridor. [thieme-connect.com]

  Children may otherwise present with cough, dyspnea, or irritability 2,6. Most (70-90%) foreign bodies are organic, most commonly seeds and nuts. Inorganic foreign bodies vary dramatically and can include teeth, coins, pins, pens/crayons, etc. [radiopaedia.org]

  Large pharyngeal foreign body → peracute respiratory dyspnea and acute dysphagia. A life-threatening respiratory obstruction may occur if a large foreign body becomes firmly lodged. [vetstream.com]

  Objects that are only partially obstructing and thus compatible with life may cause hoarseness, croupy cough, aphonia, odynophasia, haemoptysis, wheezing and varying degrees of dyspnea. [jiom.com.np]

• Inspiratory Stridor

  They presented with severe attacks of inspiratory stridor, difficulty in breathing and spitting blood. Indirect laryngoscopy revealed a dark greenish living foreign body in the larynx in each case. [ncbi.nlm.nih.gov]

  Ask the patient to cough ; aspirated foreign objects can often be ejected in this manner, especially if they have not passed the level of the glottis (Zitzmann et al. 2000) If coughing leads to choking, respiratory difficulties or inspiratory stridor, [med-college.hu]

• Choking

  choking (symptom), choke, CHOKING, Choking (finding), Choking (finding) [Ambiguous], Choking Czech Dušení, dušení se Hungarian Fuldoklás Norwegian Kveling Dutch verstikking, Stikken Ontology: Foreign body in pharynx (C0161010) Concepts Injury or Poisoning [fpnotebook.com]

  Choking Food or small objects can cause choking if they get caught in your throat and block your airway. This keeps oxygen from getting to your lungs and brain. [icdlist.com]

  787.03 asphyxia 933.1 causing asphyxia, choking, or suffocation (see also Asphyxia, food) 933.1 [icd9data.com]

  […] to avoid a choking emergency. [stanfordchildrens.org]

  Ruben H, Macnaughton FI (1978) The treatment of food-choking. Practitioner 221:725–729 PubMed Google Scholar 22. [link.springer.com]

• Odynophagia

  In this article, we report a patient with unusual laryngeal foreign body lodgement: a bee which presented with sudden odynophagia and stinging sensation in throat. [ncbi.nlm.nih.gov]

  […] bones Buttons and tacks Marbles or screws Button batteries Straight pins In adults, the most commonly impacted foreign body are food boluses (hot dogs, etc), followed by Fish bones Coins Fruit pits Straight pins Dentures Clinical Findings Dysphagia Odynophagia [learningradiology.com]

  The typical patient with perforation has a good history of foreign body ingestion along with: Severe chest and/or neck pain Odynophagia Aphagia or drooling Tachycardia Tachypnoea Pyrexia Sometimes surgical emphysema, torticollis or trismus Imaging Plain [entsho.com]

  Usual symptoms were history of ingestion of F.B., along with dysphagia, odynophagia, and sensation of foreign body in throat, excessive salivation, pain in neck, vomiting and/or retrosternal pain. [ispub.com]

  Sometimes even a piece of bone within a meal can lead to perforation of the oesophagus and even injure the pericardium and myocardium. [ 3 ] If an object perforates the oesophagus, it tends to cause acute mediastinitis with chest pain, dyspnoea and severe odynophagia [patient.info]

• Cyanosis

  Typical anamnesis in the case of aspiration of a foreign body into the lower respiratory tract is a paroxysmal cough connected with cyanosis of the patient. [czytelniamedyczna.pl]

  If blockage is complete, then can have cyanosis and severe distress / arrest. Trachea – similar to larynx in presentation, but can have biphasic stridor, dry cough. Often appear uncomfortable or scared. [pedemmorsels.com]

  There was no cyanosis or intercostal retractions. Indirect endoscopic examination revealed an irregular object on the right vocal cord with thick secretions (Fig. 1). Soft tissue lateral x-ray was obtained which was inconclusive. [waent.org]

  Acute symptoms Frequent touching of the throat by the distressed patient Facial paleness followed by cyanosis Coughing Choking, vomiting Early complications Acute respiratory distress (dyspnea) Respiratory depression or arrest due to airway obstruction [med-college.hu]

  May see choking, gagging, coughing, and/or cyanosis. High risk of death. Second phase: Quiescent asymptomatic period. May last minutes to months depending on location, type, and ease of movement of the foreign body. [hawaii.edu]

• Headache

  Haug Browse recently published Learning/CME Learning/CME View all learning/CME CME Case 3-2019: A 70-Year-Old Woman with Fever, Headache, and Progressive Encephalopathy Caplacizumab Treatment for Acquired Thrombotic Thrombocytopenic Purpura Randomized [nejm.org]

  Boy With Worsening Respiratory Function: A Case History A 6-year-old boy with well-controlled asthma presented to the emergency department (ED) with a 2-day history of fever, headache, productive cough, and dyspnea. [consultant360.com]

• Stroke

  On the other hand, the elderly are those with thoracic neurological disease, decreased gag reflex due to alcohol seizures, stroke, Parkinsonism, trauma and senile dementia [ 6 ]. [bmcearnosethroatdisord.biomedcentral.com]

• Seizure

  On the other hand, the elderly are those with thoracic neurological disease, decreased gag reflex due to alcohol seizures, stroke, Parkinsonism, trauma and senile dementia [ 6 ]. [bmcearnosethroatdisord.biomedcentral.com]

The initial workup is the same as with any foreign body sensation in the throat. [ncemi.org]

Ruben H, Macnaughton FI (1978) The treatment of food-choking. Practitioner 221:725–729 PubMed Google Scholar 22. [link.springer.com]

The treatment is based on endoscopy under general anesthesia to remove the foreign body. So overall there are few problems for the diagnosis of foreign body larynx, the treatment involves a series of difficulties already mentioned in part. [scirp.org]

He presented with a history of intractable cough that did not respond to any treatment. On flexible fiberoptic laryngoscopy, he had a bluish string originating in the trachea and emerging between the vocal cords. [ghorayeb.com]

The management of the aspiration or swallowing of foreign bodies during dental treatment Schweiz Monatsschr Za [med-college.hu]

The precise location of any solid object can be determined by a bronchoscope, which can be also used to extract the body (see Treatment). [health-tutor.com]

Despite the delay in diagnosis, the conduct of the expert was essential for the patient's prognosis. [thieme-connect.com]

The prognosis remains however encumbered with a mortality and a morbidity not insignificant. In underdeveloped countries like ours, the difficulties in the management of this affection are numerous. [scirp.org]

Treatment and prognosis Bronchoscopy is considered the gold standard in the diagnosis of tracheobronchial tree foreign bodies 3, with the added benefit of being able to potentially retrieve the foreign body. [radiopaedia.org]

Prognosis : generally good. Pathogenesis Etiology Foreign body is accidentally inhaled and becomes lodged in either the nasal passages or the pharynx depending on size. [vetstream.com]

[…] endoscopically Once they pass into stomach, such batteries pose a lower risk Complications Always check for lead lines in children (pica) Longer the FB remains impacted (>24hrs), higher incidence of perforation Perforation Stricture Diverticulum formation Prognosis [learningradiology.com]

Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]

Pathogenesis Etiology Foreign body is accidentally inhaled and becomes lodged in either the nasal passages or the pharynx depending on size. Predisposing factors General Wood chewing, eg crib-biter Behavior: crib-biting and wind-sucking. [vetstream.com]

Mortality Another report by Cheng and colleagues determined that between 2000 and 2009, US pediatric inpatients with airway foreign bodies had a weighted mortality rate of approximately 2.75%, with the rate staying relatively unchanged over that period. [4] Etiology [emedicine.medscape.com]

The aim of this study was to identify epidemiological, clinical and therapeutic features that characterize the foreign bodies of the larynx in our context in order to make the inventory of fixtures. 2. [scirp.org]

Epidemiology Aspiration of foreign bodies by children can lead to serious illness and sometimes even death. [pedsinreview.aappublications.org]

Epidemiology Frequency Most airway foreign body aspirations occur in children younger than 15 years; children aged 1-3 years are the most susceptible. [emedicine.medscape.com]

Epidemiology The ingestion of foreign bodies is most commonly a problem in young children aged 6 months to 5 years. [patient.info]

Epidemiology Ages affected (typical range 1 to 4 years old) Age under 3 years old: 50% Age under 4 years old: 80% Age under 10 years old: 95% Increased Incidence at holiday time Known object aspiration in less than 40% of cases Choking deaths related [fpnotebook.com]

Pathophysiology The physical presence of the foreign body causes an obstruction and irritation. Timecourse Large foreign bodies will cause acute onset clinical signs. Smaller foreign bodies may result in more chronic duration of clinical signs. [vetstream.com]

Pathophysiology After foreign body aspiration occurs, the foreign body can settle into 3 anatomic sites, the larynx, trachea, or bronchus. Of aspirated foreign bodies, 80-90% become lodged in the bronchi. [emedicine.medscape.com]

A small proportion of foreign bodies become impacted in the larynx, when urgent recognition is required to prevent disaster. [ncbi.nlm.nih.gov]

This mechanism prevents food from entering the trachea. 3 The larynx and the cough reflex is an important defense mechanism which prevents entry of a foreign body into respiratory tract. [waent.org]

It is important that the medical fraternity is aware of the presence of foreign body airway, since early diagnosis and intervention prevent a potentially fatal outcome. [thieme-connect.com]

Heimlich HJ, Hoffman KA, Canestri FR (1975) Food-choking and drowning deaths prevented by external subdiaphragmatic compression-Physiological basis. Ann Thorac Surg 20:188–195 PubMed CrossRef Google Scholar 23. [link.springer.com]

Foreign bodies should be removed within 24 hours to prevent erosive changes. The majority of objects that have passed into the stomach will go through the GI tract. [pedclerk.bsd.uchicago.edu]