Removal of a foreign body from the throat

A foreign body in the pharynx is a foreign particle, not chewed food, microorganisms that accidentally got into the funnel-shaped canal and bring pain and discomfort to a person. Due to the foreign body, the mucous membrane suffers, it can also cause the lumen to close to the upper respiratory tract (larynx, bronchial tree and trachea). If an infection enters the funnel-shaped canal, oxygen starvation may develop.

The primary manifestations of foreign objects in the pharynx are: a feeling of perspiration, an urge to vomit, a sensation of a foreign particle, the inability to swallow food and saliva, it becomes difficult to breathe, there is increased hypersalivation and severe pain in the throat. It is possible to diagnose that a foreign body is stuck in the pharynx using x-rays, pharyngoscopy and anamnestic information. After an accurate diagnosis is made, therapy is carried out – a foreign object is removed. The doctor can remove the foreign particle naturally or it is removed as a result of surgical intervention.

Locations of foreign bodies in the pharynx

The pharynx is the so-called barrier that prevents foreign objects from entering the trachea, larynx or gastrointestinal tract. When an object enters the funnel-shaped canal, a reflex contraction of the muscles occurs, which do not let it pass further. Of great importance is the mucous membrane, which immediately reacts to foreign bodies.

Foreign objects are most often located in the piriform sinuses, lateral ridges, epiglottic fossae, posterior wall of the oropharynx, palatine and lingual tonsils. Often, the objects taken out are bones, which can be in the throat along with food.

Often the reason for the ingress of foreign particles is the inattention of a person during a meal, excessive talking or laughter. Nails, pins, small metal objects, screws, erasers and other household foreign objects can get into the mouth if a person holds them between the lips.

Toddlers may also try to swallow small things and objects, but only because of the lack of parental attention to what their children are doing. Older people who have dentures and other structures in their mouths are at risk of being swallowed.

Sometimes a foreign body may end up in the throat due to the mistakes of doctors during various procedures. It can be tools, cotton wool, bandage. Microorganisms can also “attack” the pharynx, and they enter retrograde from the gastrointestinal tract, with untreated water and during the inhalation of oxygen.

What are the types of foreign particles?

Foreign particles are divided into several types depending on in which part of the funnel-shaped channel they are located. In this regard, doctors distinguish 3 parts of the pharyngeal cavity: the larynx, which passes into the pharynx (lower), the mouth, which passes into the funnel-shaped canal (middle), and the nose, which passes into the pharyngeal cavity (upper). Often there are household items in the middle and lower parts of the canal. In the upper part, household items are rarely localized, this is due to paralysis of the sky.

Foreign objects by their nature are iatrogenic, living, food and household. Most often, particles in the form of fish and meat bones, insufficiently well-chewed pieces of food, appear in the funnel-shaped channel. Household particles that can be found in the throat include coins, buttons, dentures, pieces of wood or glass, small toys and parts, needles, pins, screws, and nails.

Cotton swabs, dental drills, pieces of medical instruments that are used in surgical and dental procedures are considered iatrogenic items. Foreign particles can enter the funnel-shaped canal when removing adenoids, prosthetics and pulling out teeth, treating caries, removing malignant and benign pathological formations, and removing the tonsil.

Living bodies include: leeches (may be in the throat while drinking unclean water or swimming in a lake or river), worms (for example, roundworms from the gastrointestinal tract can move into the throat), insects (when inhaling air, beetles and flies can accidentally “stop” in the funnel-shaped channel).

Also, foreign particles of the pharynx enter the cavity due to internal and external factors. As a result of internal factors, particles and organisms enter the mouth in an ascending way or arise directly in the funnel-shaped canal. These include worms and petrifications. Due to external factors, objects penetrate from the outside through the oral or nasal cavity.

What symptoms indicate the presence of foreign particles in the funnel canal?

The manifestation of symptoms depends on the parameters, location, shape, residence time and type of household particles in the funnel-shaped channel. Common symptoms include:

• unbearable sore throat;
• increased hypersalivation;
• feeling of itching;
• dry cough;
• discomfort in the pharynx;
• difficulty swallowing;
• giving pain in the ear or larynx.

If the body is even a short period of time in the oropharynx, then the person has vomiting. When an object passes into the esophagus or larynx, it injures the mucous membrane, because of which a person may feel pain and sore throat. Foreign bodies with sharp ends are localized in the oropharynx and “stops” their root of the tongue. At the same time, a person feels as if someone is cutting or pricking him from the inside. The pain is aggravated during swallowing of saliva and food, talking, laughing and deep breathing.

Sharp objects provoke muscle spasms of the pharynx, due to which a person cannot swallow, eat and drink. Pain and muscle contractions cause swallowing disorders. Saliva cannot be swallowed, it flows out of the mouth. This fact negatively affects the condition of the lips, as an inflammatory process and maceration occur.

Large objects can partially block the laryngeal lumen and interfere with calm breathing. With complete obstruction of the entrance to the cavity of the larynx, asphyxia occurs and oxygen does not enter the larynx and trachea.

How is the diagnosis of foreign objects in the throat?

Diagnosis of foreign bodies in the funnel-shaped canal is not a problem for surgeons. It is much more difficult to identify small objects in the folds of the mucosa and hypopharynx. To determine the localization and parameters of the subject, pharyngoscopy and x-rays are performed. Radiography is prescribed in order to determine the focus of the pathology.

With the threat of movement of a foreign body into the esophagus, larynx or nose, it is necessary: ​​rhinoscopy, esophagoscopy, x-ray of the esophagus with a contrast agent and laryngoscopy. If a person tries to pull out a bone or other object himself, he injures the pharynx and its mucous membrane very much, therefore this should not be done.

Sometimes patients complain and assure doctors that they have something in the pharyngeal cavity, such symptoms may appear due to malignant and benign tumors in the pharynx, inflammation, and disorders of the nervous system.

How is the foreign body removal procedure performed?

Absolutely any object located in the pharynx that interferes with breathing and leading a normal life should be removed. If the foreign body is well visualized and there is direct access to it, the surgeon or otolaryngologist can remove it using special tools (Brunings forceps, tweezers or nose forceps). After removal of the body, the damaged area is treated with antiseptic preparations or Lugol’s solution. After the removal procedure, the patient is advised to eat only soft food for 5-7 days.

There are problems with objects that are located in the larynx. To remove them, the doctor injects atropine to reduce salivation. The manipulation is quite serious and is performed under local anesthesia. During the operation, the specialist uses a mirror for the larynx and forceps.

If a hard-to-reach body is stuck in the patient’s throat, laryngoscopy is suitable for removing it. Objects localized in soft tissues cannot be removed naturally. This also applies to those cases when, due to a foreign object, swelling and inflammation occur. In this situation, it is possible to get rid of the interfering particle only with the help of surgical intervention (the surgeon makes an incision in the throat and removes the object).

A person needs first aid when a foreign body causes asphyxia and it becomes impossible to breathe. This is a direct threat to the health of the patient and it is impossible to delay the operation. The doctor examines the problem of the patient and tries to eliminate it. If this cannot be done naturally, you will have to resort to surgical intervention.

Possible complications after removal

Even a slight injury by a foreign particle of the mucous membrane of the funnel-shaped canal is accompanied by an inflammatory process, severe pain, swelling and hyperemia. Foreign bodies cause serious damage not only to the mucous membrane, but also to internal tissues. During removal, an infection can be introduced, which in the future can cause lateral, paratonsillar and retropharyngeal abscesses of the pharynx.

After successfully pulling out a foreign object, you need to follow the doctor’s recommendations. Treat the affected area with the necessary medicines, adhere to dietary nutrition and additionally do not injure the pharyngeal cavity. Within 5-7 days after the removal of the object, the pharynx and mucous membrane will begin to recover and heal. A week after the manipulation, it is advisable to get an examination by a surgeon or an otolaryngologist.