Fish bones in the vallecula and tongue base: removal with the rigid nasal endoscope

The tongue base and vallecula are common anatomical sites for impaction of inadvertently swallowed fish bones. Many techniques for their removal have been described but this apparently simple procedure can still pose a surgical challenge. We describe a previously unreported technique using rigid endoscopy with the 4 mm 30 degree Hopkins' rod as a visual aid for transoral removal of the impacted bone. The technique has proved to be very well tolerated by the patient and more acceptable in terms of morbidity, time and resources than either flexible endoscopy or rigid endoscopy under general anaesthetic.