A Rare Incidental Finding of a Foreign Body in the Nasopharynx during Adenotonsillectomy

Abstract

Diverse foreign bodies may become lodged in the aerodigestive tract, and the discovery of such foreign bodies is an expected scenario for health-care practitioners. The foreign body insertion may be accidental or deliberate, and the object may be organic or inorganic. Most accidental foreign body aspirations occur in children, and some such cases are potential threats that go unnoticed. Very few cases of foreign bodies in the nasopharynx have been reported. Herein, we describe an unusual case in which a foreign body in a child's nasopharynx went unnoticed for 1 year and was detected intraoperatively.

A rare nasopharyngeal foreign body (detached beverage can stay-tab): A case report

“…Aspirated foreign bodies in children present with most signs and symptoms that are nonspecific, and in unwitnessed aspiration cases, the diagnosis might be delayed, which increases morbidity and the likelihood of chronicity [1] . Self-inserted foreign bodies in the upper aero-digestive tract are common in children because they are habitually inquisitive for their natural body orifices [3] .…”

“…There have been more than 12,000 reported cases of aspirated foreign bodies in pediatrics in peer-reviewed literature that required bronchoscopic removal [1] . Foreign body ingestion and inhalation is a very common problem in children but nasopharyngeal foreign body aspiration in young aged children is rare and very uncommon [2] .…”

“…Foreign body ingestion and inhalation is a very common problem in children but nasopharyngeal foreign body aspiration in young aged children is rare and very uncommon [2] . Patient's history, reported symptoms and imaging are the clinically made suspicions for nasopharyngeal foreign body, but bronchoscopy is used for definite diagnosis and removal of foreign body [1] .…”

Clinical presentation, diagnosis and management of aerodigestive tract foreign bodies in the paediatric population: Part 2

“…Most of the documented literature available on posterior nasopharyngeal FBs are case reports, and reported objects include a ring, a tooth, a leech and even a fish. 40 The transit and subsequent impaction of a FB into the posterior nasopharynx can occur from various cases, such as forceful emesis and coughing causing an upward migration of the FB from the pharynx or oesophagus into the posterior nasopharynx, migration of a FB into the posterior nasopharynx during extraction attempts, traumatic penetration into the posterior nasopharyngeal space or an iatrogenically placed posterior nasopharyngeal FB after surgery. The diagnosis of a posterior nasopharyngeal FB can be challenging as the symptoms are variable and some patients may remain asymptomatic.…”

“…The diagnosis of a posterior nasopharyngeal FB can be challenging as the symptoms are variable and some patients may remain asymptomatic. 40 , 41 Radiologists need to be aware of the posterior nasopharynx as a possible site for FB impaction, especially in patients with a presenting history of aspiration, as in rare situations, FBs may be discovered in the posterior nasopharynx on imaging studies performed for evaluation of other regions of the body ( Figure 17a and b ).…”