Pharyngeal foreign body
Introduction
Pharyngeal foreign body introduction Pharyngeal foreign body is one of the common emergencies in otolaryngology. It is easy to be found and removed. If it is not properly treated, it often delays the disease and occurs seriously. Larger foreign bodies or severe trauma can cause pharyngeal damage. basic knowledge Sickness ratio: 0.5% Susceptible people: no specific population Mode of infection: non-infectious Complications: laryngeal edema pneumonia acute mediastinal inflammation sepsis
Cause
Pharyngeal foreign body cause
1. Inadvertent diet, caused by unchewed food or fish bones, bones, and nucleus mixed in food.
2. Children play, put small toys, coins, etc. into the mouth, cry, laugh, and fall into the throat when they fall.
3. The sensation of the pharynx in the elderly is poor, the teeth are detached, and chewing is not sufficient, which is prone to this disease.
4. Psychiatric patients, coma, drunkenness, seizures, pharyngeal spasm, suicide, swallowing foreign bodies when anesthesia is not awake.
5. When the head and neck are injured, foreign matter such as shrapnel remains in the pharyngeal cavity.
6. In the operation, hemostasis, cotton balls, needles, etc. are mistakenly left in the nasopharynx and tonsils.
Prevention
Pharyngeal foreign body prevention
If the foreign body of the respiratory tract has already developed disease, do not blindly use your fingers to dig it, or attempt to swallow vegetables, taro and other foreign objects to avoid serious consequences.
Oropharyngeal foreign bodies generally have no adverse consequences, and the mortality rate of throat foreign bodies is less than 1%. .
Complication
Pharyngeal foreign body complications Complications laryngeal edema pneumonia acute mediastinal sepsis
Trauma caused by foreign body or failure to remove in time should lead to laryngeal edema, pharynx, neck abscess, subcutaneous abscess, aspiration pneumonia, mediastinal inflammation, sepsis, major bleeding and other serious complications.
Symptom
Pharyngeal foreign body symptoms Common symptoms Tongue and pharyngeal burning sensation when brushing teeth, nausea and pharyngeal paraesthesia, pharyngeal foreign body, fever, congestion, suffocation
Detailed medical history and analysis of symptoms can be initially diagnosed. Most patients have a history of foreign body swallowing and foreign bodies are found during physical examination. Some patients start to have stinging. No foreign body is seen during the examination. It may be caused by mucosal abrasions. Generally, the duration is short. For the painful part, there is a foreign body in the pharynx. If it occurs several days later, it should be distinguished from pharyngeal paraesthesia or chronic pharyngitis.
Neck fluoroscopy, radiography and swallowing examination can determine the presence or absence of foreign bodies and the presence of the disease.
1. Nasopharyngeal foreign body: less common, more common in children, trauma or surgery accidents, the history is unknown, often have nasal obstruction symptoms, nasal discharge with odor, may have unexplained fever and other symptoms, can be accompanied by eustachian tube Inflammation, otitis media, etc., the examination is easy to neglect and missed diagnosis.
2. Oropharyngeal foreign body: common, foreign matter remains in the tonsils, tongue roots or epiglottis, often small foreign bodies, easy to penetrate into the tissue or hidden in the place where it is difficult to find, the symptoms vary depending on the type of foreign body and the site of penetration. Often consciously tingling in the throat, intensified when swallowing, avoid turning the neck more, the patient can point out the location of the pain.
3. Throat and throat foreign body: more common in the pear-shaped fossa or ring, the symptoms are the same as oropharyngeal foreign body, because the foreign body is larger, more difficult to swallow; stimulate the laryngeal mucosa, it may have itching, cough, and even cause laryngeal mucosal edema, hematoma Wait, such as blocking the entrance of the throat, there may be a risk of suffocation, sometimes due to cough, swallowing, vomiting and other actions to cause foreign bodies to be spit out or swallowed.
Check: foreign body can be found by gland sphincter or indirect laryngoscopy. Foreign body remains in the nasopharynx for a longer period of time. There are purulent sputum in the nasal cavity, mucosal congestion or purulent matter in the posterior part of the lower armor. Invasion, pharyngeal tissue may have blood stasis, hematoma, etc., the surrounding tissue of the piercing site often has inflammatory manifestations when the time is long, and the larger oropharynx and throat throat foreign body often smashed to the neck outside to the obvious tenderness. In the area, if the throat or trachea is pushed toward this area, the pain is aggravated.
Examine
Examination of foreign bodies in the pharynx
Pharyngeal foreign body is generally seen in oropharyngeal examination or in indirect laryngoscopy and nasopharyngoscopy. If it is a X-ray-free foreign body, X-ray film can be used to check the positioning.
Diagnosis
Diagnosis and diagnosis of pharyngeal foreign body
diagnosis
Detailed medical history and analysis of symptoms can be initially diagnosed. Most patients have a history of foreign body swallowing and foreign bodies are found during physical examination. Some patients start to have stinging. No foreign body is seen during the examination. It may be caused by mucosal abrasions. This symptom usually lasts for a short time.
Differential diagnosis
For the painful part, there is a foreign body in the pharynx. If it occurs several days later, it should be distinguished from pharyngeal paraesthesia or chronic pharyngitis.
