FOREIGN BODIES OF THE LARYNGOPHARYN AND ESOPHAGUS WITH DIFFERENT CLINICAL COURSE AND TREATMENT TACTICS

Abstract

Foreign bodies of the laryngopharynx and esophagus are a complex problem of practical otolaryngology. Untimely diagnosis and removal of foreign bodies often lead to the development of severe and life-threatening complications. The clinical picture depends on the type of foreign body, shape, size, level of its retention, and the nature of the damage to the esophagus.

The article describes three cases of foreign bodies of the laryngopharynx in the area of ​​the first narrowing of the esophagus with a different clinical picture from minor discomfort and inconvenience when swallowing to severe pain and dysphagia, hyperthermia, inspiratory dyspnea. Two patients are women 68 and 71 years old and a man 42 years old. By nature, the foreign bodies are represented by chicken bones, in one case - a cervical vertebra of a chicken. In one patient, the foreign body occurred with a typical clinical picture without complications, and in two cases – complicated foreign bodies with damage to the laryngopharyngeal wall, cervical esophagus and jugular vein with the development of phlebitis. In one case, to confirm the foreign body, a lateral Zemtsov radiography of the cervical esophagus and contrast radiography were performed, and in two cases, a CT scan of the neck organs was performed. In terms of treatment tactics, direct hypopharyngoscopy under anesthesia was used to remove the foreign body in one case, in the second – esophagoscopy with cervical esophagotomy on the left, and in the third – the foreign body of the soft tissues of the neck was removed by external access with ligation of the internal jugular vein.

The presented clinical cases indicate that foreign bodies of the laryngopharynx and esophagus are a complex problem in otolaryngology, and early diagnosis and immediate removal of foreign bodies using modern methods of anesthesia lead to recovery and form the basis for the prevention of complications.