Abstract

Topicality: It is difficult to imagine a more difficult clinical path for a patient who believes that he has a foreign object in his throat or neck. For months, the otolaryngologist is busy with consultations and examinations of the patient, starting with his specialization and ending with clinical psychologists, and sometimes worse. It is precisely such cases in the practice of medical personnel that can lead to medical errors, both in the direction of unfounded diagnostic methods (not always safe) and unnecessary surgical interventions of a revisional nature, as well as in the direction of a careless attitude towards patients with an initially undetected, but present foreign object. In connection with the above, we present our own observation of a complicated laryngopharyngeal foreign object.

Objective: to optimize the timely and safe diagnostic pathway of a patient with an initially undetected laryngopharyngeal foreign object to reduce complications.

Results: Signs of insufficient medical attention to this patient are: 1) justified persistent specific and clear complaints of the patient; 2) pronounced hyperthermia from the first hours of the disease; 3) lack of indication for palpation of the neck before performing CT with contrast. The factors that suspended the diagnostic search at the beginning of the disease are as follows: 1) absence of a foreign object in the lumen of the laryngopharynx and in its wall during repeated examinations of this area by several doctors; 2) absence of oedema and inflammation of the corresponding pyriform sinus on the 11th day of the disease during fibroscopy.

Conclusions: Contrast-enhanced CT for laryngopharyngeal foreign bodies is the so-called gold standard in the diagnosis of the described conditions, but should be used in a timely manner to address issues of tactics and surgical treatment strategy, and not instead of other, simpler to perform and safer diagnostic methods.

Keywords: foreign object, larynx, computed tomography, phlegmon of the neck.