Vocal cord paralysis caused by stingray.

Area of Science:

• Otolaryngology
• Toxicology
• Emergency Medicine

Background:

• Foreign bodies in the pharynx are common, with fish bones being the most frequent. Vocal cord fixation is an exceptionally rare complication.
• Previous cases of vocal cord fixation involved mechanical obstruction, direct nerve injury, or inflammation-induced paralysis.
• The hypopharynx is a critical area for airway and swallowing, making foreign body impaction a significant concern.

Observation:

• A patient presented with symptoms suggestive of a pharyngeal foreign body.
• The foreign body was identified as a stingray tail fragment lodged in the hypopharynx.
• The impaction led to vocal cord paralysis, a presentation distinct from typical foreign body complications.

Findings:

• Histopathological analysis confirmed the presence of stingray venom components.
• The venom was identified as the causative agent of the recurrent laryngeal nerve dysfunction.
• This represents the first reported case of vocal cord paralysis directly attributed to stingray venom in the hypopharynx.

Implications:

• Highlights the potential for envenomation from seemingly innocuous foreign bodies.
• Expands the differential diagnosis for vocal cord paralysis in emergency settings.
• Suggests the need for considering toxicological assessments in unusual pharyngeal foreign body cases.