Pharyngeal Foreign

Bodies
Sarit Levinsky
Group M1656
 Introduction
Pharyngeal foreign body (PFB) is a common emergency in
children.
The management of PFB is more difficult in children than in adults.
Most PFBs are removed in the outpatient department.
Only a few children lack cooperation and need extracting FBs in the
hospital under general anesthesia.

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Most common aspirated objects of the
pharynx
Plastic
Metal pin, needles
Seeds
Nuts
Bones (most common fish bones)
Coins
Dental appliances
Bits of wood and glass
balloons

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 Site Of Impaction
Large
pointed
FB
tonsils Base of the tongue

Small Pyriform
pointed sinus
FB

Lateral wall of the

vallecula pharynx
Hypo
-pharynx

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3 Clinical Phases
• Initial phase = choking and gasping, cough and gagging also called the
“penetration syndrome”
• Asymptomatic phase = lodge of object and relaxation of reflexes
• Complication phase = FB produces local injury or obstruction

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Symptoms
Unconscious patient:
Immediate respiratory distress

Conscious patients:
Noisy breathing with sudden onset and then persistent stridor or wheezing
Anterior jaw pain
Choking
Odynophagia
Dysphagia
Dysphonia
Stridor
Cough
Hoarseness
Sensation of something sticking in throat
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 Diagnosis
History

Physical examination, tongue depressor, headlight, mirror

Imaging:
Radiography of the head, skull, neck
CT of the skull, of the head and of the neck

Flexible / rigid endoscopy

Pharyngoscopy
Indirect laryngoscopy
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Treatment
• Perform oral removal as
outpatient if the object is
visible and easily accessible
(using Magill forceps)
• most foreign bodies in the
throat require otolaryngology
intervention with sedation
and endoscopic removal
(Hypopharyngoscopy,
laryngoscopy)

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Management in unconscious patients
Patient placed in supine position
Open airway, perform mouth to mouth ventilation (ABC)
Head tilt, chin lift, neck lift, jaw thrust
Correct airway obstruction
Back blows
Abdominal thrusts
Chest thrust (in pregnancy, children less than 8 years old)
Tongue jaw lift (lift patient’s tongue to move it away from pharyngeal
wall)

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