咽頭・頸部食道魚骨異物の3例

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Fishbones commonly lodge in the pharynx and are usually found in direct vision or pharyngolaryngoscopy. They perforate the pharyngeal or esophageal wall and penetrate the thyroid gland relatively rarely. We report three unusual cases involving fishbone migration to extrapharyngeal space. Case 1 was a 52-year-old woman reporting foreign-body sensation after swallowing a fishbone. Computed tomography (CT) showed a fishbone behind the right tonsil, removed orally in right tonsillectomy and ultrasonography. Case 2 was an 88-year-old woman reporting painful dysphagia. Ultrasonography detected a strong linear echo extending from the esophagus to the left thyroid gland lobe. The bone was removed in endoscopy, followed by an uneventful course. Case 3 was a 93-year-old woman seen for pharyngeal and anterior neck pain, found endoscopically to involve a fishbone stuck in the esophageal wall and removed endoscopically. After removal, cervical CT showed air retained in and around the left thyroid gland lobe. Cervical CT 11 days later showed a thyroid gland abscess. We continued administering antibiotics and drained pus through a syringe, enabling a successful, nonsurgical conclusion. Some 14 cases of fishbones penetrating the thyroid gland have, to our knowledge, been reported, with 13 requiring surgical intervention. Successful conservative nonsurgical intervention thus appears to be the first case in Japan of an acute thyroid abscess so treated.
耳鼻咽喉科臨床学会の論文

咽頭・頸部食道魚骨異物の3例

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