Foreign body stuck in the throat is an ENT emergency.

Here are some FAQs related to foreign body stuck in the throat.

What types of foreign bodies are there?

The most common type of foreign body in the throat is a fish bone. Some of the unusual ones I have removed include dentures, coins, and cake decorations. Even more unusual foreign bodies that I have come across include a whole brussel sprout and a toothbrush.

Is a foreign body in the throat dangerous?

The first thing is that it is uncomfortable or painful to have something stuck in the throat. That makes it difficult to eat or drink.

A foreign body can also cause infection. If the infection spreads to the deeper tissues of the neck or chest this can be serious or even life-threatening.

Foreign bodies can sometimes penetrate the wall of the food passage and work their way into the neck or chest. This can lead to serious and potentially life-threatening consequences, which fortunately are very rare. Foreign bodies that can penetrate through the wall of the food passage are typically hard, fine, spear-shaped bones.

How to diagnose a foreign body in the throat?

The history

You will likely know that something got stuck when you were eating. Furthermore, you may experience persistent discomfort or pain when you swallow. There may be a poking feeling in your throat, neck or chest.

The examination

The examination starts with feeling the neck. Rocking the windpipe gently may cause discomfort if there is a foreign body in the lower part of the throat.

Next, we examine the back of the mouth. One of the common places for fine fish bones to lodge is in the tonsils, at the back of the throat. Sometimes we can see the foreign body and can remove it straight away.

The next step in the examination is to perform a flexible endoscopic examination of the back of the tongue and voice box, as foreign bodies can also lodge in a pocket-like space, known as the vallecula, between the back of the tongue and the front of the voice box.

Neck x-ray

If the initial examination does not show up the foreign body, then we may need to do a neck x-ray to see if there is anything further down.

Special investigations

Unfortunately, not all foreign bodies show up on x-rays. If the x-ray is negative but we still think there is a foreign body, then we will need another way to find it. The options include:

CT scan of the neck and chest. This may identify a bone not visible on x-ray.

Transnasal esophagoscopy. Where available, this is an excellent means of detecting a foreign body which did not show up on x-ray. The examination involves putting a thin endoscope through the nose down into the food pipe. TNE views the food passage extremely clearly, all the way from the throat to the stomach.

When we think the likelihood of a foreign body is low then we may suggest a period of careful monitoring.

How do you remove a foreign body in the throat?

A foreign body which can be seen in the back of the mouth, is usually easy to remove.

Foreign bodies stuck at the back of the tongue require specialized tools to remove them. I have found that a very effective method of removal is by using a flexible endoscope passed through the mouth. The patient helps by staying calm and pulling their tongue gently. This allows us to maneuver the endoscope down to where the foreign body is. We use flexible forceps passed through the endoscope to grasp the foreign body and remove it through the mouth. The technique works very well for removing fine fish bones.

A large or deep foreign body may need removal under general anesthesia. We use a metal tube-like instrument known as a rigid esophagoscope. We pass the rigid esophagoscope through the mouth down into the esophagus. When the foreign body is found, it is pulled out through the esophagoscope.

Prevention is better than cure!

Always take time to chew your food well, particularly if there may be bones in it. Avoid distractions while eating. Be especially careful if you wear dentures, because you may be less aware of a bone in the food.

These steps will help you be more aware if you are about to swallow a bone. They have the added bonus of helping your digestion!

What should I do if I think I have a bone stuck in my throat?

Contact us at Advanced ENT Centre for a same-day urgent appointment. Or head to the Urgent Care Centre.

References

Lau D, Watson D. Referred otalgia: an unusual presentation of a laryngeal foreign body. Hosp Med. 1998 Feb;59(2):161. PMID: 9797895.