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Introduction <p>Foreign body ingestion is a common otorhinolaryngological emergency in children but is relatively uncommon in adults without psychiatric illness or intellectual disability. While most ingested foreign bodies remain within the aerodigestive tract lumen, migration into surrounding soft tissues is rare and can lead to serious complications.</p> Case Report <p>FA 55-year-old man presented with odynophagia and dysphagia of 36 hours' duration following consumption of chicken rice. Initial upper gastrointestinal endoscopy was normal, while video laryngoscopy showed obliteration of the right pyriform fossa. CT neck revealed a 2.6 cm chicken bone lodged in the right pyriform fossa with extension into the retropharyngeal space at the C4 level. Direct laryngoscopic removal was unsuccessful and thus an external anterior cervical pharyngotomy was performed. The postoperative course was uneventful, and the patient regained normal swallowing by six weeks.</p> Discussion <p>This case highlights the importance of CT imaging in detecting migrated hypopharyngeal foreign bodies. Sharp chicken bones may penetrate the pyriform fossa mucosa and migrate into deeper tissue planes during deglutition. Although transoral techniques are increasingly utilized, the external anterior cervical approach remains a reliable salvage procedure when endoscopic removal fails or when the foreign body lies within the retropharyngeal space.</p> Conclusion <p>Penetrating pyriform fossa foreign bodies extending into the retropharyngeal space are rare but potentially dangerous emergencies. Prompt diagnosis and timely surgical removal are essential to prevent further migration, infection, and injury to vital cervical structures.</p>

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Uncommon Penetrating Foreign Body of the Throat

  • 期刊论文

  • 发表日期：

    2026年7月4日

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  • Saai Ram Thejas

摘要

Introduction

Foreign body ingestion is a common otorhinolaryngological emergency in children but is relatively uncommon in adults without psychiatric illness or intellectual disability. While most ingested foreign bodies remain within the aerodigestive tract lumen, migration into surrounding soft tissues is rare and can lead to serious complications.

Case Report

FA 55-year-old man presented with odynophagia and dysphagia of 36 hours' duration following consumption of chicken rice. Initial upper gastrointestinal endoscopy was normal, while video laryngoscopy showed obliteration of the right pyriform fossa. CT neck revealed a 2.6 cm chicken bone lodged in the right pyriform fossa with extension into the retropharyngeal space at the C4 level. Direct laryngoscopic removal was unsuccessful and thus an external anterior cervical pharyngotomy was performed. The postoperative course was uneventful, and the patient regained normal swallowing by six weeks.

Discussion

This case highlights the importance of CT imaging in detecting migrated hypopharyngeal foreign bodies. Sharp chicken bones may penetrate the pyriform fossa mucosa and migrate into deeper tissue planes during deglutition. Although transoral techniques are increasingly utilized, the external anterior cervical approach remains a reliable salvage procedure when endoscopic removal fails or when the foreign body lies within the retropharyngeal space.

Conclusion

Penetrating pyriform fossa foreign bodies extending into the retropharyngeal space are rare but potentially dangerous emergencies. Prompt diagnosis and timely surgical removal are essential to prevent further migration, infection, and injury to vital cervical structures.