Objective: To report a case of crab shell impaction at the glottic level presenting only as aphonia and cough. Methods: Design: Case Report. Setting: Tertiary Government Hospital. Patient: One (1). Results: A 36-year-old male, who presented in emergency with sudden aphonia after a meal, was found to have crab shell with leg spines impacted at the glottic level. Due to its large size, ragged edges and the sharp spines stuck in the tissue, endoscopic removal needed a prior tracheostomy. All pieces were extracted, with no bleeding, laceration or tissue damage. The patient completely recovered with normal vocal folds and a normal voice at follow up. Conclusion Our experience suggests that an impacted foreign body may warrant a tracheostomy to secure the airway prior to extraction, and avoid any possible complications including laryngeal injury.
Human ; Male ; Larynx ; Aphonia

Osteomas are benign slow growing tumours of the paranasal sinuses. The frontal and ethmoidal sinus- es are most commonly affected. We present an unusual case of a 42-year-old Malay lady who had a frontal lobe mucocoele, secondary to an extensive frontal sinus osteoma with orbital and intracranial extension, and presenting primarily with orbital proptosis. She was successfully managed by a multi specialty team.