The fork in the road: A laryngeal filter airway foreign body

Upper aero-digestive tract foreign body management can be complicated and life threatening in both adult and pediatric populations. The variation seen with foreign bodies including shape, material, and duration of ingestion can impact clinical decision making and management. The objective of this report is to demonstrate a complicated case of upper airway obstruction by a plastic fork.

This case report presents an adult with ingestion of an intact plastic fork with acute laryngeal and cervical esophageal obstruction. The position of the fork precluded intubation as it was blocking the laryngeal inlet.

The report illustrates successful nasolaryngoscopy pre-operative evaluation, multi-disciplinary team airway management and subsequent operative airway management and fork removal.

Despite various concerns by both the Otolaryngology and Anesthesia services for airway establishment, sedation allowing for spontaneous ventilation through the fork prongs and adequate analgesia for direct laryngoscopy yielded successful removal of a plastic fork from the upper airway.