Department of Otorhinolaryngology-Head and Neck Surgery, Albert Einstein College of Medicine, Bronx, NY, USA.
Am J Otolaryngol. 2012 Nov-Dec;33(6):731-4. doi: 10.1016/j.amjoto.2012.07.004. Epub 2012 Aug 20.
To report a small case series of an unusual ingested foreign body and a new method for removal of tongue base foreign bodies.
Three patients were identified with wire bristle foreign bodies between 2009 and 2011 at our academic tertiary medical center. Their medical records were reviewed and are described in this report.
Each patient presented to our medical center with progressive pain after ingestion of barbecued food. For 2 patients, the metallic bristle foreign body was imbedded within the lingual tonsil. In these 2 cases, radiofrequency plasma ablation (coblation) assisted partial lingual tonsillectomy was performed to identify the foreign body. In a third case, the foreign body presented as a complex deep space neck abscess and an open trans-cervical approach was required.
While oropharyngeal and esophageal foreign bodies are common, there are only a few case reports describing this particular foreign body. The presentation of an imbedded wire grill brush bristle can be insidious. Persistent pain and foreign body sensation should be taken seriously in patients with a history of barbecue food ingestion. Intraoperatively, wire bristles can be difficult to localize and extract. Radiofrequency plasma assisted lingual tonsillectomy may be helpful for identifying and removing foreign bodies that are imbedded in the tongue base. Grill brushes should undergo stringent safety regulation, as ingested wire bristles are difficult to localize and remove and may cause significant morbidity.
报告一个罕见的咽下异物的小病例系列和一种新的舌根异物取出方法。
在我们的学术型三级医疗中心，于 2009 年至 2011 年间发现了 3 例钢丝刷毛异物。回顾了他们的病历，并在本报告中进行了描述。
每位患者在咽下烤肉食物后均出现进行性疼痛而就诊于我院。对于 2 名患者，金属刷毛异物嵌入舌扁桃体。在这 2 例中，采用射频等离子体消融（电切）辅助部分舌扁桃体切除术来识别异物。在第 3 例中，异物表现为复杂的深部颈部脓肿，需要进行经颈前路开放性手术。
虽然口咽和食管异物很常见，但仅有少数病例报告描述了这种特殊的异物。嵌入式铁丝烤刷刷毛的表现可能是隐匿的。对于有烤肉食物摄入史的患者，持续性疼痛和异物感应引起重视。术中，钢丝刷毛可能难以定位和取出。射频等离子体辅助舌扁桃体切除术可能有助于识别和取出嵌入舌根部的异物。烤刷应进行严格的安全监管，因为咽下的刷毛难以定位和取出，可能会导致严重的发病率。
