Cervical esophageal foreign body. (Esophagoscopy Clinic).
This case illustrates the limitations of foreign-body removal via TNE. The small size of the 2-mm forceps makes grasping irregularly shaped objects difficult. Compared with rigid esophagoscopy, TNE does not allow for good visualization of the postcricoid region. In addition, the airway is unprotected during TNE, and foreign-body aspiration is a concern. Even if a foreign body were to be safely grasped and removed from the esophagus via TNE, it would still have to be withdrawn through the tight nasal vault.
Our approach to the patient with a suspected esophageal foreign body is to perform TNE for diagnostic purposes only, unless it is a distal esophageal foreign body. TNE requires no sedation, and it offers better diagnostic accuracy than does radiologic evaluation. If a distal foreign-body impaction is discovered, we attempt to gently push the bolus into the stomach. Otherwise, once the diagnosis is made, the patient is taken to the operating room for rigid esophagoscopy.
From the Center for Voice Disorders, Department of Otolaryngology, Wake Forest University, Winston-Salem, N.C., www.thevoicecenter.org. and the Scripps Center for Voice and Swallowing, La Jolla, Calif.
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|Author:||Koufman, James A.|
|Publication:||Ear, Nose and Throat Journal|
|Article Type:||Brief Article|
|Date:||Jan 1, 2003|
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