Nasendoscopy guided removal of fish bones from the base of tongue and the vallecula

Impaction of a fish bone at the base of tongue or the vallecula is a very common problem. Removal of the bone from these sites without a general anaesthesia can be challenging to surgeons and patients alike. Various manoeuvres to facilitate this procedure have been described, some are very successful but may require specialized instruments, while others may cause excessive discomfort to the patients and even inadvertent dislodgement of the bone. We describe a method using a flexible fibreoptic nasendoscope to provide a visual guide in order to facilitate peroral removal of the bone with a pair of forceps. This method is well tolerated by patients and avoids the need for a general anaesthesia in many cases.