Foreign bodies are one of the most frequently observed accidental cases in the otolaryngological fields. Most of food pieces as foreign bodies are removable with a laryngoscope or a esophagoscope, etc. But sometimes surgical removal is needed, as in the two interesting cases we experienced of fish bones. One case was misconceived as tongue cancer at first, and the other case dealt with the migration of a fish bone from hypopharynx to the cervical space We removed them surgically. So we report these cases with a review of literature.
Esophagoscopes ; Foreign Bodies* ; Hypopharynx ; Laryngoscopes ; Neck* ; Tongue Neoplasms ; Tongue*

Aged ; Anesthesia, General ; Dentures ; Esophagoscopes ; Esophagus ; surgery ; Foreign Bodies ; Humans ; Male

Shotgun injury compared to gunshot injury has been reported to have tendency to make less severe damage due to its characteristic low velocity and fragmentation. Recently, we encountered with a patient who survived from shotgun injury. She shot herself for the purpose of suicide with a hunting gun. The multiple fragmented bullet particles were found on the nasal septum, inferior turbinate, near the sphenoid sinus, and especially in the esophagus. They were removed safely with nasal endoscope, C-arm, and esophagoscope. We report this case with review of literature.
Endoscopes ; Esophagoscopes ; Esophagus ; Head* ; Humans ; Nasal Septum ; Neck* ; Sphenoid Sinus ; Suicide ; Turbinates ; Wounds and Injuries*

BACKGROUND: In most cases of a foreign body in the esophagus, an ENT specialist is consulted, which may be time consuming if not evaluated in a timely fashion. The patients are admitted to the hospital and sent to the operating room, where they are placed under anesthesia and the object is removed by using an esophagoscope. METHODS: A prospective randomized trial was conducted during the period from January 1998 to June 2000. All patients presenting to emergency department with blunt objects in the esophagus were included. In one group, with fluoroscopic guidance, a Foley catheter was placed to remove the blunt foreign bodies. And in the other group, we removed them by using the esophagoscpe. We used the t-test for statistical analysis in this study. RESULTS: Total number of patients enrolled in this study was 38. 22 patients were enrolled in the Foley Catheter removal group, and the remaining 16 were enrolled in the esophagoscope removal group. The success rate for the Foley catheter was 21/22(95.5%), and that for the esophagoscope was 15/16(93.8%). The average time of removal for the Foley catheter group was 0.70+/-0.28 hours while that for the esophagoscope group was 5.96+/-2.22 hours. One side effect, nonfatal hypoxia, was noted in the Foley catheter removal group. The average cost for the Foley catheter group were 78,800 won(approximately 60 US dollars) while that for the esophagoscope group took 722,800 won(approximately 600 US dollars). CONCLUSION: In our study, we found that the success rate for removing blunt foreign bodies from the esophagus by using a simple Foley catheter was high, also the Foley catheter was a time saving and cost effective procedure with an excellent safety profile.
Anesthesia ; Anoxia ; Catheters* ; Emergencies* ; Emergency Service, Hospital* ; Esophagoscopes ; Esophagus ; Foreign Bodies* ; Humans ; Operating Rooms ; Prospective Studies ; Specialization

Here, we report a case of corrosive injury-induced pharyngeal stricture in a 69-year-old female, which was successfully treated with endoscopic adhesiolysis using an electrosurgical knife. The patient had ingested sodium hydroxide in an attempted suicide, and immediate endoscopy revealed corrosive injuries of the pharynx, esophagus, and stomach. When a liquid diet was permitted, she complained of nasal regurgitation of food. Follow-up endoscopy revealed several adhesive bands and a web-like scar that did not allow passage of the endoscope into the hypopharyngeal area. For treatment of the hypopharyngeal stricture, the otolaryngologist attempted to perform an excision of the fibrous bands around the esophageal inlet using microscissors passed through an esophagoscope, but this procedure was not effective. We then dissected the mucosal adhesion and incised the adhesive bands using an electrosurgical knife. After this procedure, nasal regurgitation of food no longer occurred. To our knowledge, this case is the first report of endoscopic adhesiolysis with an electrosurgical knife in a patient with a corrosive injury-induced pharyngeal stricture.
Adhesives ; Aged ; Bays ; Cicatrix ; Constriction, Pathologic ; Diet ; Endoscopes ; Endoscopy ; Esophagoscopes ; Esophagus ; Female ; Follow-Up Studies ; Humans ; Hydroxides ; Pharynx ; Sodium Hydroxide ; Stomach ; Suicide, Attempted

Surgery for a mid-esophageal lesion requires an open thoracotomy, But authors resected out a stenotic thoracic esphageal lesion with laparoscopic instrument without open thoracotomy. The patient was 50 years old woman with a long history of progressive dyaphagia. A small (3 cm in diameter) smooth ovoid submucosal mass lesion was found at 26 cm distal from incisor on both esophagoscopy and esophagogram. Two 5 mm and two 10 mm trocars were inserted into the right pleural cavity under general anesthesia with double lumen endotracheal tube, An induced pneumothorax by insuffulation of CO2 gas made lung collapse and a good exposure of esophagus. Transorally introduced esophagoscope helped to demonstrate the exact location of lesion and also to give a guide at safe excision of mass with prevention of mucosal perforation. The lesion was found to be a congromeration of an inflammed hilar lympnode and hypertorphic esophageal muscle. The entire lesion was carefully dissected from esphageal mucosa and resected out en bloc. A chest tube was introduced through a trocar site. The lung was reinflated immediately. Post-operatively patient was very comfortable. Laparoscopic surgery is very effective and safe, and it could be applied for the resection of lung bullae, benign pulmonary neoplasm and for an excision of benign esophageal tumor.
Anesthesia, General ; Chest Tubes ; Esophagoscopes ; Esophagoscopy ; Esophagus ; Female ; Humans ; Incisor ; Laparoscopy ; Lung ; Lung Neoplasms ; Middle Aged ; Mucous Membrane ; Pleural Cavity ; Pneumothorax ; Pulmonary Atelectasis ; Surgical Instruments ; Thoracotomy*