Fish bone stuck in vallecula

Case contributed by Craig Hacking
Diagnosis certain

Presentation

Three days of foreign body sensation in throat after eating fish.

Patient Data

Age: 65 years
Gender: Male
x-ray

Long thin calcified foreign body located in the anterior aspect of the vallecula, abutting the base of the tongue. No gas identified in the neck soft tissues. No prevertebral soft tissue thickening.

Annotated image

Annotated images of the fish bone in the vallecula.

Case Discussion

The ENT surgeon subsequently removed the bone from the vallecula.

The most common site of swallowed foreign body impaction in the upper aerodigestive tract is the pharynx at the level of the tonsils. An impacted bone may also be found the vallecula, tongue base or pyriform fossa 1.

Interestingly, dentures are the most important risk factor for ingestion of foreign bodies, due to the impairment of palatal sensory feedback during swallowing 1. Other risk factors include 1:

  • rapid eating
  • elderly
  • young age
  • alcohol abuse
  • mental retardation

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