Vertical Cricoid Lamina Ossification: A Rare Pitfall in the Diagnosis of Extraluminal Foreign Body

Abstract

of extraluminal foreign body impaction. The patient had a foreign body at the cricopharynx which was removed endoscopically and the check X-ray showed a remnant foreign body which was again confirmed by CT scan neck. A lateral pharyngotomy and neck exploration was carried out, which concluded it as vertical ossification of cricoid lamina and not remnant foreign body. CASE REPORTA 40-year-old gentleman presented in our department with the complaint of accidental ingestion of fish bone (head part of fish) 2 days back and thereafter persistent foreign body sensation throat. On examination his general condition was satisfactory. Vital parameters were well maintained. Throat examination was normal. Indirect laryngoscopy showed pooling of saliva in both pyriform fossae but no foreign body. Neck movements were painless but laryngeal crepitus was absent. Systemic examination was essentially normal.In view of the positive clinical history, persistent symptoms and clinical examination findings, an X-ray of the soft tissue neck lateral view was taken. It showed an irregular shaped radiopaque foreign body at the level of C5-C6 with no significant prevertebral widening or air shadow or air fluid level (Fig. 1). An emergency hyopharyngoscopy was done under local anesthesia. The foreign body was found at the cricopharyngeal level and the surrounding mucosa was found inflamed. It was removed endoscopically and was a 1.5 cm sized, irregular shaped fish bone broken into ABSTRACTOssification of airway cartilages on plain X-ray film may masquerade as a foreign body in the digestive tract in some patients with a history of foreign body ingestion. This process may cause confusion to the clinician, who then has to rely on other investigations and explorative surgery to exclude the possibility of an impacted or extraluminally migrated foreign body. Here we present a pitfall in the diagnosis of extraluminal foreign body impaction secondary to vertical ossification of cricoid lamina, which resulted in an explorative surgery.

Calcified triticeal cartilage: a red herring

“…C alcification of the airway cartilage seen on plain neck radiographs becomes a dilemma to many physicians, as it mimics a foreign body. This mostly involves the calcification process of the posterior part of the thyroid cartilage, the posterior part of the cricoid cartilage and the arytenoid cartilage (1) , which is a part of the aging process. Albeit a myriad of cases have been reported on calcified laryngeal cartilage feigning a foreign body, to our knowledge this is the second reported case involving calcified triticeal cartilage.…”