Department of Otolaryngology, Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
PLoS One. 2021 Aug 17;16(8):e0255947. doi: 10.1371/journal.pone.0255947. eCollection 2021.
Fish bones are common foreign bodies in the upper aero-digestive tract, but their clinical features in relation to fish species have not been confirmed. We aimed to clarify the clinical characteristics of fish-bone foreign bodies and their location and removal methods depending on the fish species.
Retrospective, observational, monocentric study.
From October 2015 to May 2020, 368 patients visited the Department of Otolaryngology-Head and Neck Surgery at Tohoku University Hospital complaining of dysphagia, sore throat, or pharyngeal discomfort after eating fish. We analyzed the patients' sex and age distribution, foreign-body location, type of the fish, and the techniques used for removing the foreign body.
Fish bones were confirmed in the upper aero-digestive tract in 270 cases (73.4%), of which 236 (87.4%) involved fish-bone foreign bodies in the mesopharynx. The most frequently involved site was the palatine tonsil (n = 170). Eel was the most frequently observed fish species (n = 39), followed by mackerel (n = 33), salmon (n = 33), horse mackerel (n = 30), and flounder (n = 30). Among the 240 cases in which the bones did not spontaneously dislocate, 109 (45.4%) were treated by endoscopic removal (103 cases) or surgery (6 cases). In pediatric cases (<12 years old), almost all fish bones were found in the mesopharynx (138/139, 99.3%), and 31 cases (22.3%) required endoscopic removal. Flounder fish bones were often lodged in the hypopharynx and esophagus (9/30, 30%), hindering spontaneous dislocation and frequently necessitating endoscopic or surgical removal (19/29, 65.5%).
The characteristics of fish-bone foreign bodies differed depending on the fish species. Flounder bones were often stuck in the hypopharynx and esophagus and were likely to require more invasive removal methods. Confirming the species of the fish could facilitate appropriate diagnosis and treatment of fish-bone foreign bodies.
鱼骨是上呼吸道-消化道常见的异物，但与鱼类种类相关的临床特征尚未得到证实。本研究旨在阐明不同鱼类引起的鱼骨异物的临床特征及其位置和取出方法。
回顾性、观察性、单中心研究。
2015 年 10 月至 2020 年 5 月，368 名因吃鱼后出现吞咽困难、咽痛或咽部不适而就诊于东北大学医院耳鼻喉科的患者，我们分析了患者的性别和年龄分布、异物位置、鱼类种类以及取出异物的技术。
270 例（73.4%）患者的上呼吸道-消化道中证实有鱼骨，其中 236 例（87.4%）为中咽部鱼骨异物。最常累及的部位是腭扁桃体（n=170）。鳗鱼是最常见的观察鱼类（n=39），其次是鲭鱼（n=33）、三文鱼（n=33）、马鲛鱼（n=30）和比目鱼（n=30）。在 240 例鱼骨未自行脱位的患者中，109 例（45.4%）接受内镜取出（103 例）或手术（6 例）治疗。在儿科病例（<12 岁）中，几乎所有的鱼骨都位于中咽部（138/139，99.3%），其中 31 例（22.3%）需要内镜取出。比目鱼的鱼骨常位于下咽和食管（n=30，30%），阻碍了鱼骨的自行脱位，经常需要内镜或手术取出（n=29，65.5%）。
鱼骨异物的特征因鱼类种类而异。比目鱼的鱼骨常卡在下咽和食管，更可能需要采用侵入性更强的取出方法。确认鱼类的种类有助于对鱼骨异物进行适当的诊断和治疗。
