Migratory Foreign Bodies in the Neck: Possible Role for Endoscopic Surgery

Abstract

 Foreign body ingestion is a common ENT emergency case among the pediatric popu
lation. Most of the ingested foreign bodies pass naturally through the gastrointestinal (GI) tract 
without any complications; however, in about 10% of these cases may require a non-operative 
intervention and less than 1% may require a surgical procedure. Sharp ingested foreign bodies 
may lodge in the base of the tongue, the palatine tonsil, the pyriform sinus, the vallecula, and 
the oesophagus. Only a small number of those lodged foreign bodies may perforate the phar
ynx or the oesophagus and even a smaller number may migrate extraluminally. Transversely 
oriented foreign bodies have a larger tendency to perforate the wall of the hypopharynx and the 
oesophagus. This happens due to a local inflammation plus the contractions of the hypopharynx 
muscles during deglutition which leads the foreign body to penetrate the wall. Most of these 
migratory foreign bodies are usually sharp objects like fish bone, chicken bone or metallic 
components.