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Factors associated with the true location of ingested fishbones
Yen-Ting Lu1,2,3, Hung-Wen Chen4, Yao-Ying Tseng1
1Departments of Otolaryngology.
Summary
Patient age and fishbone length are key factors in determining the location of ingested fishbones. Flexible nasopharyngoscopy is effective for diagnosis and treatment, while lateral neck radiography is not recommended for pharyngeal fishbone ingestion.
Area of Science:
- Otolaryngology
- Gastroenterology
- Medical Imaging
Background:
- Fishbone ingestion is a prevalent global issue requiring precise localization for effective management.
- Current diagnostic methods lack comprehensive analysis of factors influencing fishbone location.
Purpose of the Study:
- To identify predictors of true fishbone location in the pharynx.
- To develop a management algorithm for fishbone ingestion based on identified factors.
Main Methods:
- Retrospective study of 198 patients with pharyngeal fishbone ingestion.
- Analysis of patient demographics, fishbone characteristics, and diagnostic imaging.
- Evaluation of transoral direct vision and flexible nasopharyngoscopy for removal.
Main Results:
- Fishbone locations: tonsil (36.4%), tongue base/vallecula (56.6%), hypopharynx (7.0%).
- Patient age and fishbone length were significant predictors of location (p<0.05).
- Lateral neck radiography sensitivity was only 22%; flexible nasopharyngoscopy sensitivity was high.
Conclusions:
- Age and fishbone length are crucial independent factors for fishbone location.
- Lateral neck radiography is ineffective for pharyngeal fishbone diagnosis.
- Flexible nasopharyngoscopy is a valuable tool for diagnosing and treating pharyngeal fishbone ingestion.
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