Cricoid ossification mimicking an impacted foreign body

Wakisaka, Naohiro; Miwa, Takaki; Yoshizaki, Tomokazu; Furukawa, Mitsuru

doi:10.1017/s0022215106002003

Cited by 16 publications

(7 citation statements)

References 4 publications

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“…Conventional radiology nowadays plays no role in the diagnosis of laryngeal pathology. The radiologists and the pathologists should, however, be aware of the anatomy of these structures so as to not misdiagnose disorders [28,29]. For the detection of foreign bodies, conventional radiography is often used; Mu et al [30], however, demonstrated in large pediatric series that this is not sensitive to tracheal and laryngeal foreign bodies, with 80% (32/40) of children with laryngotracheal foreign bodies showing a normal chest radiograph.…”

Section: Imaging Of the Hyoid And Larynx In Generalmentioning

confidence: 99%

Embryology, normal anatomy, and imaging techniques of the hyoid and larynx with respect to forensic purposes: a review article

Soerdjbalie‐Maikoe

Rijn

2008

Forensic Sci Med Pathol

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Experiences with pre- and postmortem imaging in a forensic setting create more and more interest. If autopsy is permitted, forensic pathologists perform careful examination of the neck structures, which plays an important role as this is decisive in the diagnostics of compressive neck injury. Primary tools are important: forensic pathologists and radiologists are supposed to be aware of the complex anatomy of the neck, especially the laryngeal region, to interprete their findings at autopsy and after imaging. It is of great interest whether CT and MR imaging techniques would be useful in comparing findings of autopsy and document findings if autopsy is refused. In the light of this, the embryology, anatomy and a review of imaging techniques of the neck will be highlighted in this article, with special attention to the value of updated imaging techniques of the larynx for forensic purposes in living people and postmortem.

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Section: Imaging Of the Hyoid And Larynx In Generalmentioning

confidence: 99%

Embryology, normal anatomy, and imaging techniques of the hyoid and larynx with respect to forensic purposes: a review article

Soerdjbalie‐Maikoe

Rijn

2008

Forensic Sci Med Pathol

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“…Ossification of the laryngeal cartilages normally Clinical Pediatrics 50 (1) begins when skeletal growth is otherwise complete, in males at 20 and females at 22 years of age. 4 The degree of calcification increases with age, and in some people the calcification in the posterior lamina of the cricoid is more dense. This may appear as a linear opacity separated from the rest of the cricoid on a lateral neck X ray.…”

Section: Discussionmentioning

confidence: 99%

“…Computerized tomography of the neck can confirm the presence of a calcified cricoid cartilage. 4,5 There are only a few reported cases of cricoid calcification, all of which are described in patients older than 40 to 50 years from Asian countries, and all were initially thought to have an esophageal or tracheal fish bone foreign body. Our case came to the emergency room with relatively rapidly progressing upper respiratory problems and did not have a history of foreign body ingestion or aspiration.…”

Section: Discussionmentioning

confidence: 99%

A Teenager With Neck Pain

Toprak

Friedlander

Kiernan

2010

Clin Pediatr (Phila)

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An 18-year-old previously healthy Caucasian female college freshman presented to our emergency department (ED) with a temperature of 38.8°C, sore throat, difficulty in swallowing, neck pain, and neck stiffness that had increased in severity over the previous 12 hours.Her illness began with a nonproductive cough 10 days earlier. Two days before presentation to our ED, she developed sore throat and generalized muscle pain and went to the student health center of her college. A rapid streptococcal antigen swab test was negative, a strep culture was obtained, and the patient was treated symptomatically with acetaminophen. The strep throat culture was still pending when she came into our emergency room for her ongoing symptoms. She had no other pertinent medical history.Physical exam in our ED included vital signs, which were normal except for a temperature of 38.5C. Neck exam revealed stiffness with pain-limited flexion and extension of 35° to 45° in all 4 directions. She had tender and mobile bilateral 1 × 1 cm submandibular lymphadenopathy with normal overlying skin. Exudate on the right tonsil with posterior pharyngeal hyperemia was visible on exam. No peritonsiller or retropharyngeal abscesses were observed. Respiratory, cardiovascular, and abdominal examinations were normal. Because of the severity of the presenting symptoms, AP and lateral neck X rays were obtained. There were no abnormalities on the AP neck X ray, but on the lateral neck X ray (Figure 1) an irregular 2-cm-long vertical opacification posterior to the airway was seen, which suggested a possible foreign body or calcified mucus concretion secondary to bacterial tracheitis. Flexible laryngoscopy limited to the supraglottic area was performed by otolaryngology, which did not show any exudate in the larynx. On flexible bronchoscopy the subglottic region and larynx appearance were normal. Mild erythema of the tracheal mucosa was noted. Otherwise the trachea, main carina, and left and right main stem bronchi were normal. No foreign bodies were observed. Hospital CourseThe patient was started on conservative treatment including oral acetaminophen with codeine for pain management and intravenous antibiotic coverage for bacterial pathogens known to cause peritonsillar cellulitis, formerly termed quinsy. A repeat lateral neck X ray was obtained to determine if the opacity was still present. This film was partially oblique and showed that the opacity was actually a paired structure (Figure 2) and the diagnosis was then apparent. The patient's symptoms improved overnight, and the patient was discharged the following morning. DiagnosisCricoid cartilage calcification mimicking a foreign body.

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“…Here, we report a linear ossification of cricoid cartilage mimicking a fish bone in the upper digestive tract. Only few cases of vertical linear ossification of cricoid cartilage lamina posteriorly are reported in the literature [4, 6, 7], and we report this case due to its rarity and propensity for misdiagnosis and unnecessary explorative surgery like cervical esophagotomy [8].…”

Section: Introductionmentioning

confidence: 99%

Cricoid Ossification Mimicking an Esophageal Foreign Body: A Victim of Overdiagnosis

Bhardwaj

Tuli

et al. 2021

Dubai Med J

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Laryngeal cartilages undergo ossification, usually after the third decade of life. Variations exist in the extent and age of onset of ossification. Radiologically, these ossified cartilages may mimic an aerodigestive tract foreign body. We present an unusual case where the ossified cricoid cartilage masqueraded as a fish bone in the aerodigestive tract. A 48-year-old male patient presented to us with a foreign body sensation and throat pain after consuming fish. We found no fish bone on endoscopic laryngopharyngeal assessment but noted a linear opacity against the C-6 vertebral body in the aerodigestive tract on a lateral X-ray film of the neck. Rigid esophagoscopy also did not reveal any foreign object, but a computed tomography (CT) scan showed a linear hyperdensity in the wall of the aerodigestive tract, against the C-6 vertebral body, due to linear ossification in the midline of the cricoid lamina posteriorly. The patient’s symptoms improved within 1 week of anti-reflux medications, and he remains asymptomatic. It is possible to encounter such rare cases of cartilage ossification while dealing with foreign body aerodigestive tract in adult patients in clinical practice. Proper assessment using CT scan prevents unnecessary procedures and anxiety to the patient.

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Cricoid ossification mimicking an impacted foreign body

Cited by 16 publications

References 4 publications

Embryology, normal anatomy, and imaging techniques of the hyoid and larynx with respect to forensic purposes: a review article

Embryology, normal anatomy, and imaging techniques of the hyoid and larynx with respect to forensic purposes: a review article

A Teenager With Neck Pain

Cricoid Ossification Mimicking an Esophageal Foreign Body: A Victim of Overdiagnosis

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