Mastoidotympanoplasty was not found to be superior to tympanoplasty alone over a short term follow-up period. Hence, it may not be necessary to undertake routine mastoid exploration at this stage of disease.

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Background Esophageal foreign body impaction is one of the common reasons of referral to Ear Nose Throat clinic. It is a medical emergency requiring urgent evaluation and treatment. Esophageal foreign body in a very young child can be a diagnostic challenge. Case presentation In this case, we report an unusual sharp foreign body in the upper aerodigestive tract of a 20-month-old female child. It was neglected and misdiagnosed in the initial phase and was treated as a case of upper respiratory tract infection. Chest X-ray done was suggestive of a radiopaque irregular sharp foreign body at the level of the 6th cervical vertebra. The patient underwent rigid esophagoscopy on an urgent basis, and the foreign body was removed without any complication. Conclusion Esophageal foreign body in a very young child can mimic upper respiratory tract infection due to atypical symptoms. Strong witness history along with X-rays of the neck, chest, and abdomen help in making the immediate diagnosis. Clinicians should always advise parents for supervision of their children during play.