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Chen YS, Luo SD, Lee CH, Lin JF, Lin TY, Ko SF, Yu CC, Chiang PL, Wang CK, Chiu IM, Huang YT, Tai YF, Chiang PT, Lin WC. Improving detection of impacted animal bones on lateral neck radiograph using a deep learning artificial intelligence algorithm. Insights Imaging 2023; 14:43. [PMID: 36929090 PMCID: PMC10020388 DOI: 10.1186/s13244-023-01385-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 02/04/2023] [Indexed: 03/18/2023] Open
Abstract
OBJECTIVE We aimed to develop a deep learning artificial intelligence (AI) algorithm to detect impacted animal bones on lateral neck radiographs and to assess its effectiveness for improving the interpretation of lateral neck radiographs. METHODS Lateral neck radiographs were retrospectively collected for patients with animal bone impaction between January 2010 and March 2020. Radiographs were then separated into training, validation, and testing sets. A total of 1733 lateral neck radiographs were used to develop the deep learning algorithm. The testing set was assessed for the stand-alone deep learning AI algorithm and for human readers (radiologists, radiology residents, emergency physicians, ENT physicians) with and without the aid of the AI algorithm. Another radiograph cohort, collected from April 1, 2020, to June 30, 2020, was analyzed to simulate clinical application by comparing the deep learning AI algorithm with radiologists' reports. RESULTS In the testing set, the sensitivity, specificity, and accuracy of the AI model were 96%, 90%, and 93% respectively. Among the human readers, all physicians of different subspecialties achieved a higher accuracy with AI-assisted reading than without. In the simulation set, among the 20 cases positive for animal bones, the AI model accurately identified 3 more cases than the radiologists' reports. CONCLUSION Our deep learning AI model demonstrated a higher sensitivity for detection of animal bone impaction on lateral neck radiographs without an increased false positive rate. The application of this model in a clinical setting may effectively reduce time to diagnosis, accelerate workflow, and decrease the use of CT.
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Affiliation(s)
- Yueh-Sheng Chen
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Sung, Kaohsiung, 83305, Taiwan
| | - Sheng-Dean Luo
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Chi-Hsun Lee
- Next E-Commerce Technology Co., LTD., Taichung, Taiwan
| | - Jian-Feng Lin
- Next E-Commerce Technology Co., LTD., Taichung, Taiwan
| | - Te-Yen Lin
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Sung, Kaohsiung, 83305, Taiwan
| | - Sheung-Fat Ko
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Sung, Kaohsiung, 83305, Taiwan
| | - Chiun-Chieh Yu
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Sung, Kaohsiung, 83305, Taiwan
| | - Pi-Ling Chiang
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Sung, Kaohsiung, 83305, Taiwan
| | - Cheng-Kang Wang
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Sung, Kaohsiung, 83305, Taiwan
| | - I-Min Chiu
- Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Yii-Ting Huang
- Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Yi-Fan Tai
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Sung, Kaohsiung, 83305, Taiwan
| | - Po-Teng Chiang
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Wei-Che Lin
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Sung, Kaohsiung, 83305, Taiwan. .,Department of Radiology, Jen Ai Chang Gung Health, Dali Branch, Taichung, Taiwan.
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Oh GM, Jung K, Kim JH, Kim SE, Moon W, Park MI, Park SJ. Can the patient pinpoint where the ingested fish bone is impacted?: A single-center, retrospective study. Medicine (Baltimore) 2022; 101:e29399. [PMID: 35905236 PMCID: PMC9333482 DOI: 10.1097/md.0000000000029399] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Among the plethora of foreign body impactions, fish bones are common examples that patients may struggle to properly disclose in clinical situations. This study investigated whether patients could pinpoint where the ingested fish bone was lodged. In addition, we investigated the differences between fish bone and other foreign bodies, the usefulness of computed tomography (CT), and the related risk factors for hospitalization. The cases of patients who underwent an endoscopic removal of fish bone between April 2008 and April 2020 were retrospectively reviewed. The clinical outcomes, X-ray scan, CT, and complications of each patient were investigated. A total of 96 patients were included in this study. The mean size of the impacted fish bone was 23.78 mm, and most were found in the upper esophagus (n = 38). There was a weak correlation between pain location and the actual lesion location (r = 0.419, P < .001). Compared to those of other foreign bodies, the location of impacted fish bones was different (P < .001), the X-ray detection rate of fish bones was lower (P < .001), and the complication incidence was higher (P = .030). CT (95.89%) showed higher sensitivity than X-ray scanning (11.24%) (P < .001). Foreign body size (P = .004) and door-to-endoscopy time (P = .029) were related to admission. Patients only managed to point out the approximate location of the ingested fish bone. CT detected fish bones well, but scans should include at least the entire esophagus instead of solely the area where pain is felt. Fish bone impaction has different clinical characteristics from other foreign bodies. Endoscopic removal without delay can reduce the admission rates.
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Affiliation(s)
- Gyu Man Oh
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Kyoungwon Jung
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
- *Correspondence: Kyoungwon Jung, Department of Internal Medicine, Kosin University College of Medicine, 262 Gamcheon-ro, Seo-gu, Busan 49267, Korea (e-mail: )
| | - Jae Hyun Kim
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Sung Eun Kim
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Won Moon
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Moo In Park
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Seun Ja Park
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
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Aksakal C. Management of foreign bodies in the ear, nose and throat in children: a review of 829 cases from Northern Anatolia. Otolaryngol Pol 2021; 74:1-5. [PMID: 33028735 DOI: 10.5604/01.3001.0014.1579] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
<b>Objective:</b> The aim of this study was to evaluate cases of of ear, nose and pharyngeal (ENT) foreign body (FB) in pediatric patients referred to the pediatric emergency department of the Department of Otorhinolaryngology in Tokat State Hospital (Turkey). <br><b>Methods:</b> The paper comprises a retrospective study of all ENT foreign bodies presented to the pediatric emergency Department of Otorhinolaryngology in Tokat State Hospital (Turkey) between January 1, 2012 and December 31, 2018. Subject to evaluation were also demographic and clinical characteristics of the patients, types and anatomic locations of FBs, locations of FB by age groups, the method used to remove FBs and the distribution of FB cases by months. <br><b>Results:</b> A total of 829 FB cases were evaluated in this study. The mean age of patients was 47.8 ± 31.4 months. Of all patients, 404 (48.5%) were male, and 425 (51.2%) were female. The nose (58.7%) and the ear (20.2%) were the most common anatomical locations followed by mouth/pharynx/tonsil (12.3%), esophagus (6.2%) and the laryngotracheobronchial tree (2.4%). The most common FBs in different locations were beads in the nose (30.8%), beads in the ear (32.1%), fishbones in the mouth/pharynx/tonsil (56.8%), nuts and peanuts in laryngotracheobronchial tree (70%) and a coin/disc battery in the esophagus (80.7%). <br><b>Conclusion:</b> FB in ENT is among the emergency conditions that require different diagnostic and treatment approaches based on anatomic localizations. Proper vision, adequate equipment and immobilization are important in the removal of ENT foreign bodies in children.
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Affiliation(s)
- Ceyhun Aksakal
- Department of Otorhinolaryngology, Tokat State Hospital, Tokat, Turkey
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Investigative strategies for fish bone foreign bodies during the coronavirus disease 2019 pandemic: an analysis of ENT UK guidelines. The Journal of Laryngology & Otology 2021; 135:250-254. [PMID: 33632367 PMCID: PMC7948105 DOI: 10.1017/s0022215121000669] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background By nature of their specialty, otolaryngologists are disproportionately exposed to coronavirus disease 2019 through aerosol-generating procedures and close proximity to the oropharynx during examination. Methods Our single-centre, retrospective study analysed the pertinence of guidelines produced by ENT UK to improve the investigation and management of suspected upper aerodigestive fish bone foreign bodies during the coronavirus disease 2019 pandemic. Results Our results demonstrated 43.3 per cent (n = 13) low-risk cases and 56.7 per cent (n = 17) moderate-risk cases. Nine fish bones (two low risk, seven moderate risk) were found; none of these were confirmed with X-ray and three (moderate risk) required nasoendoscopy for diagnosis. One patient required rigid pharyngoscopy. Conclusion This study confirms that soft tissue neck X-ray and flexible nasoendoscopy are unnecessary in low-risk cases; however, early nasoendoscopy in higher suspicion cases is appropriate. Recommendations are made about the long-term sustainability of these guidelines, and additional measures are encouraged that relate to repeat attendances and varying prevalence of coronavirus disease 2019 in the hospital catchment area.
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Somasundaram E, Dillman JR, Crotty EJ, Trout AT, Towbin AJ, Anton CG, Logan A, Wieland CA, Felekey S, Coley BD, Brady SL. Automatic Detection of Inadequate Pediatric Lateral Neck Radiographs of the Airway and Soft Tissues using Deep Learning. Radiol Artif Intell 2020; 2:e190226. [PMID: 33937841 DOI: 10.1148/ryai.2020190226] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 05/07/2020] [Accepted: 06/17/2020] [Indexed: 11/11/2022]
Abstract
Purpose To develop and validate a deep learning (DL) algorithm to identify poor-quality lateral airway radiographs. Materials and Methods A total of 1200 lateral airway radiographs obtained in emergency department patients between January 1, 2000, and July 1, 2019, were retrospectively queried from the picture archiving and communication system. Two radiologists classified each radiograph as adequate or inadequate. Disagreements were adjudicated by a third radiologist. The radiographs were used to train and test the DL classifiers. Three technologists and three different radiologists classified the images in the test dataset, and their performance was compared with that of the DL classifiers. Results The training set had 961 radiographs and the test set had 239. The best DL classifier (ResNet-50) achieved sensitivity, specificity, and area under the receiver operating characteristic curve of 0.90 (95% confidence interval [CI]: 0.86, 0.94), 0.82 (95% CI: 0.76, 0.90), and 0.86 (95% CI: 0.81, 0.91), respectively. Interrater agreement for technologists was fair (Fleiss κ, 0.36 [95% CI: 0.29, 0.43]), while that for radiologists was moderate (Fleiss κ, 0.59 [95% CI: 0.52, 0.66]). Cohen κ value comparing the consensus rating of ResNet-50 iterations from fivefold cross-validation, consensus technologists' rating, and consensus radiologists' rating to the ground truth were 0.76 (95% CI: 0.63, 0.89), 0.49 (95% CI: 0.37, 0.61), and 0.66 (95% CI: 0.54, 0.78), respectively. Conclusion The development and validation of DL classifiers to distinguish between adequate and inadequate lateral airway radiographs is reported. The classifiers performed significantly better than a group of technologists and as well as the radiologists.© RSNA, 2020.
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Affiliation(s)
- Elanchezhian Somasundaram
- Department of Radiology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Ave, MLC 5033, Cincinnati, OH 45229
| | - Jonathan R Dillman
- Department of Radiology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Ave, MLC 5033, Cincinnati, OH 45229
| | - Eric J Crotty
- Department of Radiology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Ave, MLC 5033, Cincinnati, OH 45229
| | - Andrew T Trout
- Department of Radiology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Ave, MLC 5033, Cincinnati, OH 45229
| | - Alexander J Towbin
- Department of Radiology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Ave, MLC 5033, Cincinnati, OH 45229
| | - Christopher G Anton
- Department of Radiology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Ave, MLC 5033, Cincinnati, OH 45229
| | - Angeline Logan
- Department of Radiology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Ave, MLC 5033, Cincinnati, OH 45229
| | - Catherine A Wieland
- Department of Radiology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Ave, MLC 5033, Cincinnati, OH 45229
| | - Samantha Felekey
- Department of Radiology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Ave, MLC 5033, Cincinnati, OH 45229
| | - Brian D Coley
- Department of Radiology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Ave, MLC 5033, Cincinnati, OH 45229
| | - Samuel L Brady
- Department of Radiology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Ave, MLC 5033, Cincinnati, OH 45229
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Diagnostic Accuracy of Lateral Neck Radiography for Esophageal Foreign Bodies in Adults. AJR Am J Roentgenol 2020; 215:465-471. [PMID: 32406772 DOI: 10.2214/ajr.19.21870] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVE. The objective of our study was to evaluate the accuracy of signs on lateral neck radiography for the assessment of patients with suspected esophageal foreign bodies (FBs). MATERIALS AND METHODS. This retrospective study was conducted of 235 adult patients between January 2012 and December 2017. Group 1 was composed of 95 patients with esophageal FBs, and group 2 was composed of 140 patients without esophageal FBs. Four signs on lateral neck radiography were recorded in both groups: presence of abnormal radiopaque density, presence of abnormal air column lucency, loss of cervical lordosis, and increased prevertebral soft-tissue thickness. The prevertebral thickness was also evaluated in three groups of patients categorized by patient age: 19-29 years old, 30-59 years old, and 60 years old or older. RESULTS. The accuracy of the presence of abnormal radiopaque density, presence of abnormal air column lucency, loss of cervical lordosis, and increased prevertebral soft-tissue thickness was 84.3%, 66.8%, 54.0%, and 60.9%, respectively. Combined two signs of presence of radiopaque density with air column lucency provided the highest accuracy, 90.6%. The prevertebral thickness at C6 of group 1 was 14.28 ± 3.19 mm (mean ± SD), and the prevertebral thickness at C6 of group 2 was 13.34 ± 2.54 mm (p = 0.018). CONCLUSION. Lateral neck radiography is helpful for the initial evaluation of patients with suspected esophageal FBs. The presence of radiopaque density or air column lucency provided the highest practical diagnostic value. Loss of cervical lordosis, as a single diagnostic sign, did not seem to provide a diagnostic advantage. Despite the variations in values for the three age groups, clinicians should be alert regarding increased prevertebral thickness at C6 especially when it is more than 20 mm.
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Roebuck DJ, Murray C, McLaren CA. Imaging of Airway Obstruction in Children. Front Pediatr 2020; 8:579032. [PMID: 33262961 PMCID: PMC7686033 DOI: 10.3389/fped.2020.579032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 10/09/2020] [Indexed: 11/23/2022] Open
Abstract
Various imaging techniques may be used to diagnose airway obstruction in children. Digital radiography, computed tomography and magnetic resonance imaging are the most important modalities, but the choice of technique will depend on the level and nature of suspected obstruction, as well as patient-specific factors such as age and ability to cooperate. This review examines the forms of airway obstruction that are commonly encountered in childhood.
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Affiliation(s)
- Derek J Roebuck
- Department of Medical Imaging, Perth Children's Hospital, Nedlands, WA, Australia.,Division of Pediatrics, Medical School, University of Western Australia, Crawley, WA, Australia
| | - Conor Murray
- Department of Medical Imaging, Perth Children's Hospital, Nedlands, WA, Australia
| | - Clare A McLaren
- Department of Medical Imaging, Perth Children's Hospital, Nedlands, WA, Australia.,School of Molecular and Life Sciences, Curtin University, Bentley, WA, Australia
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Dubey PK. Eye of the Needle, Stuck in the Middle. J Emerg Med 2019; 57:e89-e90. [PMID: 31416650 DOI: 10.1016/j.jemermed.2019.06.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Revised: 06/14/2019] [Accepted: 06/15/2019] [Indexed: 10/26/2022]
Affiliation(s)
- Prakash K Dubey
- Department of Anesthesiology & Critical Care Medicine, Indira Gandhi Institute of Medical Sciences, Patna, India
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Tollefson CR, Hiebert EC, Lee AM, Gambino JM. What Is Your Diagnosis? J Am Vet Med Assoc 2018; 253:1405-1407. [PMID: 30451625 DOI: 10.2460/javma.253.11.1405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Migratory Fish Bone in the Thyroid Gland: Case Report and Literature Review. Case Rep Med 2018; 2018:7345723. [PMID: 29560016 PMCID: PMC5842739 DOI: 10.1155/2018/7345723] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 01/16/2018] [Indexed: 11/24/2022] Open
Abstract
Introduction Foreign body stuck in the throat is a common emergency case, which can be removed by the endoscopic treatment. Fish bones are one of the common observed foreign bodies in the pharynx or cervical esophagus. Fish bones have a risk of damaging the mucosa when lodged in the upper digestive tract. Foreign bodies of fish bones located outside the laryngopharyngeal tissue are relatively unusual, and it is even more rare that they remain in the thyroid. It may cause local infection, abscess formation, large blood vessels rupture, and other serious life-threatening complications when the position of the fish bone migrates to the neck. We present a unique case of a 31-year-old woman in whom a fish bone was found in the thyroid. The fish bone had been removed successfully two months after the onset of symptoms. The relevant literature is reviewed and summarized. Case Presentation A foreign body which is located in the neck area by swallowing is usually found in the emergency case. One of the commonest foreign bodies is the fish bone. The common presenting symptoms include foreign body (FB) sensation and or a sharp pain during swallowing. But we report a rare case in which a migratory fish bone stuck in the thyroid gland was found after 3 months. We retrieved previous literature and made a summary. Conclusions Fish bones are not easy to be found as a foreign body. Surgeons should be aware that fish bones can become lodged in the thyroid gland. Combined with the history should be a wary fish bone to migrate to the case of the thyroid, to avoid misdiagnosis. To confirm the diagnosis, we can take ultrasound, computerized tomographic scanning (CT), and other tests.
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Shaukat NM, Lenz A, Desai P. Ultrasound-guided removal of hypopharyngeal foreign body in the emergency department. ULTRASOUND (LEEDS, ENGLAND) 2017; 25:245-247. [PMID: 29163661 PMCID: PMC5676525 DOI: 10.1177/1742271x17704681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 03/03/2017] [Indexed: 06/07/2023]
Abstract
Foreign body impaction at the cricopharyngeal level can be a life-threatening emergency. While traditionally, removal of these is performed in the operating room setting, patients with relatively unstable airways or significant discomfort may require immediate extraction to prevent further injury. This is the case of an 85-year-old man who presented to the emergency department in significant discomfort following aspiration of a large partial denture. We report here the first known use of ultrasound in an emergent airway situation to rapidly localize and retrieve an aspirated foreign body.
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Affiliation(s)
- Nadia Maria Shaukat
- Department of Emergency Medicine, New York Presbyterian Queens, Flushing, NY, USA
| | - Alexis Lenz
- Department of Emergency Medicine, New York Presbyterian Queens, Flushing, NY, USA
| | - Poonam Desai
- Department of Emergency Medicine, New York Presbyterian Queens, Flushing, NY, USA
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Yoo JH, Rosenberg H. How to diagnose a Canadian: a case of foreign body ingestion. CAN J EMERG MED 2014; 16:322. [PMID: 25060086 DOI: 10.2310/8000.2013.131161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Pinto A, Muzj C, Gagliardi N, Pinto F, Setola FR, Scaglione M, Romano L. Role of imaging in the assessment of impacted foreign bodies in the hypopharynx and cervical esophagus. Semin Ultrasound CT MR 2013; 33:463-70. [PMID: 22964412 DOI: 10.1053/j.sult.2012.06.009] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Impaction of foreign bodies in the upper digestive tract is a serious pathologic condition in ear, nose, and throat practice and is particularly common in children, prisoners, and psychiatric patients. Commonly found objects include fish bones, chicken bones, pieces of glass, dental prostheses, coins, and needles. The goals of the initial patient assessment are to identify the type of object, its location in the gastrointestinal tract, the presence of any associated complications, and the presence of any underlying esophageal conditions. Radiographic evaluation is helpful to confirm the location of foreign bodies and associated complications. Plain films of the neck and chest commonly will show the location of radiopaque objects, such as coins. Both anteroposterior and lateral views are necessary, as some radiopaque objects overlying the vertebral column may only be visible on the lateral view. Multidetector row computed tomography is superior to plain radiographs for the detection of pharyngoesophageal foreign bodies and provide additional crucial information for the management of complicated cases especially related to sharp or pointed ingested foreign bodies.
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Affiliation(s)
- Antonio Pinto
- Department of Radiology, Cardarelli Hospital, Naples, Italy.
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Türkmen S, Cansu A, Türedi S, Eryigit U, Sahin A, Gündüz A, Shavit I. Age-dependent structural and radiological changes in the larynx. Clin Radiol 2012; 67:e22-6. [DOI: 10.1016/j.crad.2012.07.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2012] [Revised: 06/25/2012] [Accepted: 07/05/2012] [Indexed: 11/29/2022]
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Analysing lateral soft tissue neck radiographs. Emerg Radiol 2012; 19:255-60. [DOI: 10.1007/s10140-012-1026-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2011] [Accepted: 01/24/2012] [Indexed: 10/14/2022]
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17
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The eye in the neck: removal of a sewing needle from the posterior pharyngeal wall. Case Rep Med 2010; 2010:608343. [PMID: 21209816 PMCID: PMC3014824 DOI: 10.1155/2010/608343] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2010] [Accepted: 10/25/2010] [Indexed: 11/17/2022] Open
Abstract
Foreign body ingestion is a frequent presenting complaint to most emergency departments but the finding of a sewing needle in the posterior pharynx particularly is a rare finding. We report a case of a male patient with a sewing needle lodged in the posterior pharynx despite a history suggestive of chicken bone ingestion, absent clinical features, and negative flexible endoscopic examination. The needle was only identified through cervical spine radiographs. Even subsequent pharyngoscopy, laryngoscopy, and upper oesophagoscopy all proved to be unremarkable with the patient eventually requiring a left neck exploration to remove the needle. The case outlines the importance of simple radiography in suspected foreign body ingestion, even though clinical and endoscopic findings may be unremarkable.
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Mayo Moldes M, Vázquez Lamas M, Luna Mendoza L, Pereira Loureiro M. [Nasotracheal intubation for a fiberoptic bronchoscope through the opening of the palatal connector of a removable dental prosthesis]. ACTA ACUST UNITED AC 2009; 56:254-6. [PMID: 19537269 DOI: 10.1016/s0034-9356(09)70383-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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