A Rare Case of a Hypopharyngeal Fish Bone Foreign Body with Vocal Cord Paralysis

A rare case of a hypopharyngeal foreign body (a fish bone) as long as 4cm accompanied by vocal cord paralysis is reported. A 70-year-old man visited our clinic suffering from dysphagia, swallowing pain and hoarseness. He had eaten “Namabushi” two days before his visit, which is a Japanese dish consisting of half-dried steamed bonito. Left vocal cord paralysis and edema in the left piriform sinus and the arytenoid region were observed, but we could find no foreign body using a laryngeal fiberscope. Roentgenograms and laminagrams revealed a linear, fish bone-like shadow located from the inferior edge of the thyroid cartilage to the left lateral neck area. The fish bone foreign body was removed under general anesthesia. The skin incision was developed on the left lateral neck. The fish bone had entered between the cricoid and thyroid cartilages just 2-3mm medial from the left inferior cornu and had also pierced the sterothyroid and sternohyoid muscles. Its end extended to the subcutaneous region of the neck. Vocal cord paralysis still remained on the 20th postoperative day but had disappeared on the 30th.