Senior House Officer in Otolaryngology, Southern General Hospital, Greater Glasgow & Clyde NHS trust, Glasgow, G51 3PZ.
Br Dent J. 2009 Oct 24;207(8):361-2. doi: 10.1038/sj.bdj.2009.903.
Foreign body ingestion in dental and ENT practice is a commonly encountered emergency. In most cases, particularly in adults, there is a definite history of its ingestion, the nature of the foreign body is usually identifiable and the patient almost always presents immediately. We report an unusual case of an elderly patient with a six month history of progressive dysphagia referred to us by the physicians after investigations which were highly suggestive of a hypopharyngeal malignancy. Surprisingly when a biopsy was attempted, the hypopharyngeal mass turned out to be a dental plate. Dentists and otolaryngologists should be aware that pharyngeal foreign bodies can present without a positive history and can have a clinical presentation mimicking malignancy. A history of head injury, dementia, alcohol and drug abuse should be specifically excluded. A routine examination of a patient with dysphagia should include eliciting a specific history of wearing dentures and examination of teeth. In future designs for dental plates, bridges and crowns the use of a radio opaque material should be considered.
口腔和耳鼻喉科的异物摄入是一种常见的急症。在大多数情况下，特别是在成年人中，异物的摄入有明确的病史，异物的性质通常可以识别，患者几乎总是立即出现。我们报告了一个不寻常的老年患者的病例，该患者有 6 个月的进行性吞咽困难病史，经医生检查高度提示咽恶性肿瘤后转来我院。令人惊讶的是，当试图进行活检时，发现咽肿块原来是一个牙托。牙医和耳鼻喉科医生应该意识到，咽异物可能没有明确的病史，其临床表现可能类似于恶性肿瘤。应特别排除头部外伤、痴呆、酒精和药物滥用的病史。对于有吞咽困难的患者，常规检查应包括询问佩戴假牙的具体病史和检查牙齿。在未来的牙托、牙桥和牙冠设计中，应考虑使用不透射线的材料。
