Archives of Academic Emergency Medicine

Abstract

Fish bones are frequently lodged in the upper digestive tract, usually at the palatine tonsils, tongue base, valleculae, and pyriform sinuses. The otorhinolaryngologist represents the first point of contact in such cases, which may in fact account for a sizeable percentage of ENT emergencies (1). Persistent sharp pain in the throat, experienced by the patient following eating fish, indicates that a fishbone has stuck. If the bone is not removed in a timely manner, it may result in serious septic complications (2).

Fishbone removal requires dexterity on the part of the ENT Surgeon and co-operation on the part of the patient. Removal of fishbones in the oro-pharynx or base of tongue is usually easy; bones lodged further down may require a three-hand technique, i.e. the patient or an assistant holding the tongue, and not infrequently, turn out to be an intolerable task in the outpatient setting. We Have succeeded in managing such cases under general anaesthesia without intubation, with the use of a rigid anaesthetic video-laryngoscope and a pair of Magill forceps.