Crab Shell Impaction in the Larynx with Aphonia

Abstract

Objective: To report a case of crab shell impaction at the glottic level presenting only as aphonia and cough.
 Methods
 Design: Case Report
 Setting: Tertiary Government Hospital
 Patient: One (1)
 
 Results: A 36-year-old male, who presented in emergency with sudden aphonia after a meal, was found to have crab shell with leg spines impacted at the glottic level. Due to its large size, ragged edges and the sharp spines stuck in the tissue, endoscopic removal needed a prior tracheostomy. All pieces were extracted, with no bleeding, laceration or tissue damage. The patient completely recovered with normal vocal folds and a normal voice at follow up.
 Conclusion: Our experience suggests that an impacted foreign body may warrant a tracheostomy to secure the airway prior to extraction, and avoid any possible complications including laryngeal injury.
 Keywords: foreign body, larynx, crab shell, loss of voice