Traumatic Vocal Fold Paralysis from Fishbone Foreign Body: Diagnosis and Management

Area of Science:

• Otolaryngology
• Gastroenterology
• Emergency Medicine

Background:

• Fish bone foreign bodies (FFBs) are common but pose diagnostic challenges.
• Initial presentation with fever and throat discomfort after choking can be misdiagnosed.

Observation:

• A 43-year-old female presented with symptoms mimicking viral infection post-choking incident.
• Persistent symptoms, including new-onset vocal cord paralysis, led to delayed diagnosis.
• Esophageal fish bone identified eight months later via CT scan after laryngoscopy.

Findings:

• A 2.3 cm fish bone was lodged in the esophagus, causing left true vocal cord paralysis.
• Initial chest X-ray was negative, highlighting limitations of standard imaging.
• CT scan proved essential for diagnosing the esophageal foreign body.

Implications:

• Emphasizes the need for clinical vigilance and advanced imaging (CT) for persistent symptoms like vocal cord paralysis.
• Suggests multidisciplinary surgical approaches for esophageal FFBs near major vessels.
• Underscores limitations of initial diagnostic methods in FFB cases.