Woo Seung Hoon, Kim Kyung Hee
Department of Otorhinolaryngology, Gyeongsang National University, Jinju, Republic of Korea.
the Institute of Health Sciences, Gyeongsang National University, Jinju, Republic of Korea.
Laryngoscope. 2015 Nov;125(11):2472-5. doi: 10.1002/lary.25340. Epub 2015 May 11.
To investigate the methods of diagnosis of fish bone foreign body in the esophagus and suggest a diagnostic protocol.
Prospective cohort study.
A prospective study was performed on 286 patients with a history of fish bone foreign body impaction. Among them, 88 patients had negative findings in the oral cavity and laryngopharynx. Subsequent radiologic assessment of these patients included plain radiography and computed tomography (CT). Sixty-six patients showed positive findings in the esophagus, and an attempt was made to remove the obstruction using transnasal esophagoscopy.
In 66 patients, a fish bone foreign body was detected in the esophagus by CT. In contrast, plain radiography detected a foreign body in only 30 patients. The overall detection rate of plain radiography compared with CT for fish bones was 45.5%. Plain radiography detected 35.9% of the simple type fish bones and 54.5% of the gill bone detected by CT. However, jaw bones had a detection rate of 100% with both methods. The fish bone foreign bodies were most commonly located in the upper esophagus (n=65, 98.5%), followed by the lower esophagus (n=1, 1.5%).
CT is a useful method for identification of esophageal fish bone foreign bodies. Therefore, CT should be considered as the first-choice technique for the diagnosis of esophageal fish bone foreign body.
探讨食管鱼骨异物的诊断方法并提出诊断方案。
前瞻性队列研究。
对286例有鱼骨异物嵌顿史的患者进行前瞻性研究。其中，88例患者口腔及喉咽部检查结果为阴性。对这些患者随后进行的影像学评估包括X线平片和计算机断层扫描（CT）。66例患者食管检查结果为阳性，并尝试通过鼻内镜下食管镜取出异物。
66例患者通过CT检测到食管中有鱼骨异物。相比之下，X线平片仅在30例患者中检测到异物。X线平片与CT对鱼骨的总体检出率为45.5%。X线平片检测到CT所发现的单纯型鱼骨的35.9%和鳃骨的54.5%。然而，两种方法对颌骨的检出率均为100%。鱼骨异物最常见于食管上段（n = 65，98.5%），其次是食管下段（n = 1，1.5%）。
CT是识别食管鱼骨异物的有效方法。因此，CT应被视为诊断食管鱼骨异物的首选技术。
4级。
