Laryngeal foreign bodies: Etiology, diagnosis, and treatment

Objectives: This study aimed to report our cases series involving foreign body (FB) impaction in the larynx and examine their clinical presentation, diagnostic methods, and treatment strategies in detail. Patients and Methods: This case series was conducted using file records, photographs, and video archives obtained between January 2020 and June 2024. Fifteen cases (9 males, 6 females; mean age: 52.0±19.8; range, 6 to 69 years) in which FB was detected by indirect, flexible, or direct laryngoscopic examination were presented. Results: Two cases involved ball-headed needle at the laryngeal level, one piercing the left vocal cord and the anterior inferior border of the epiglottis, and the other piercing the right aryepiglottic area. The second group of cases involved food-related FBs in the larynx. Six out of nine patients in this group had a chicken bone in the laryngeal inlet, while two had fish bones piercing the right aryepiglottic plica. One patient had a peach pit and a history of total airway obstruction. Another case involved a dental prosthesis lodged in the laryngeal inlet. Two cases involved leeches. Another case had a pen spring positioned between the band ventricles. The initial treatment step involved indirect laryngoscopy for the successful removal of FBs, while some cases required direct laryngoscopy under general anesthesia. Plain radiographs were typically the first choice for diagnostic imaging in these cases; however, computed tomography, which has a higher specificity rate for meat bones, was preferred in stable patients with prolonged symptoms. Conclusion: Urgent extraction of FBs is crucial to avoid airway injury, severe bleeding, and swelling of the larynx. The choice of anesthetic and surgical methods depends on the FB’s size, location, and characteristics and the patient's overall health status.