Most often, food (nuts, sweets, chewing gum) and small objects (balls, beads, parts of children's toys) enter the respiratory tract. Natural coughing is the most effective way to remove foreign bodies. But in the case when the airways are completely blocked, the Heimlich maneuver is used to prevent a threat to life. The purpose of this technique is to sharply push air out of the lungs, cause an artificial cough push and free the airways from a foreign body.

What to do

• Call an ambulance immediately.
• If the caregiver is alone with the victim, and the latter is already unconscious, then first, within 2 minutes, resuscitation should be carried out (artificial respiration and closed heart massage), and then call an ambulance.
• Start performing techniques to remove a foreign body from the victim's respiratory tract.

If the victim is a child under 1 year of age

The child is conscious

• Lay the baby face down on your forearm so that his chest is in your palm. Place your child's hand on your hip or knee.
• Lower the child's head below his torso.
• With the palm of your free hand, apply 5 sharp blows between the shoulder blades with an interval of 1 second.

If the foreign body cannot be removed using this technique:

• Lay the child on his back on a hard surface or keep him on his lap facing away from you. Keep the child's head lower than his torso.
• Place the middle and index fingers of both hands on the child's abdomen at a level between the navel and costal arches.
• Press vigorously on the epigastric region upward towards the diaphragm without squeezing the chest. Be very careful.
• Continue this maneuver until the airway is clear or an ambulance arrives.

Unconscious child

• Examine the oral cavity and pharynx, if you see a foreign body, and it is at the exit, remove it.
• If the foreign body could not be removed, proceed with the removal technique (Heimlich maneuver) in the same sequence as for a child under the age of 1 year who is conscious.
• Check the child's mouth and throat after each series of blows. If you see a foreign body in your throat, remove it.
• If the child is not breathing, proceed to artificial respiration, and in the absence of a pulse, to chest compressions.
• Perform resuscitation until the ambulance arrives.

If the victim is a child over 1 year old or an adult

The victim is conscious

• Stand behind the victim, wrap your arms around him. The body of the victim should be slightly tilted forward.
• Squeeze one hand into a fist and place it on the victim's stomach with the side where the thumb is located, at the level between the navel and costal arches (on the epigastric region of the abdomen).
• Grasp the fist with the palm of the other hand, quickly make 6-10 jerky pressures on the epigastric region of the abdomen inward and upward to the diaphragm.
• Continue this maneuver until the airway is clear or an ambulance arrives.

If the victim is unconscious:

• Lay the victim on their back.
• Turn his head to the side.
• Sit astride the victim's thighs, facing the head.
• Place your hands, one on top of the other, on the victim's upper abdomen (epigastric region).
• Using your body weight, forcefully push the victim's abdomen up toward the diaphragm.
• Continue this maneuver until the airway is clear or an ambulance arrives.

If the victim is not breathing, proceed to artificial respiration, and in the absence of a pulse, to chest compressions.

self help

• Clench one hand into a fist and the side where the thumb is, place it on the stomach at a level between the navel and costal arches.
• Place the palm of the other hand on top of the fist, with a quick push inward-upward, the fist is pressed into the stomach.
• Repeat several times until the airways are clear.

You can also lean on a firmly standing horizontal object (table corner, chair, railing) and push upward in the epigastric region.

What not to do

• Do not start taking Heimlich if the victim is coughing heavily.
• Do not try to grab an object stuck in the throat of the victim with your fingers - you can push it even deeper, use tweezers or other improvised tools.
• A poorly performed Heimlich maneuver is not safe because it can lead to regurgitation, damage to the stomach and liver. Therefore, the push must be performed strictly at the specified anatomical point. It is not produced in late pregnancy, in very obese people and in children under one year of age. In these cases, compression of the chest is used, as with a closed heart massage, and blows between the shoulder blades.

Next steps

The victim must be necessarily examined by a doctor - even with a favorable outcome.

The information in the article is provided for informational purposes only.

Check with your doctor before taking any action. Based on materials

One of the most critical pathologies that anyone can encounter is a foreign body in the airways. Emergency assistance in these situations should be provided instantly - in the first seconds. Certain maneuvers that everyone can master can save the life of an adult and a child if they are applied immediately.

At times more often this pathology develops in patients of childhood. This is due to the peculiarities of the behavior of babies - while eating, they tend to play, talk, laugh or cry, cough. In addition, children very often take various small objects into their mouths, which they can then accidentally inhale. The anatomical features of the oral cavity and the underdevelopment of protective reflexes in children also contribute to an increase in cases of aspiration (inhalation) of foreign bodies (FB) in young patients.

Adults most often suffer from this pathology when greedily absorbing food without chewing it, or when actively talking while eating. Another "aggravating circumstance" is alcohol intoxication, which reduces the activity of the nerve centers responsible for protective reflexes.

Symptoms of a foreign body in the airways

A feature of this pathology is that most often it occurs during meals. This is important information that suggests that a person loses consciousness precisely due to a foreign body, and not, for example, a heart attack (although this is also possible).

The clinical picture of a foreign body goes through three stages in its development:

• initial stage, in which there is a sudden strong paroxysmal cough, lacrimation, redness of the face;
• development- the cough becomes stronger, there is practically no breathing, although the patient makes respiratory movements, cyanosis appears around the lips;
• final stage, during which breathing stops, the person loses consciousness, after a short time, cardiac arrest is observed, followed by clinical death.

How to recognize a foreign body in the airways by external signs

The moment when a foreign body enters the respiratory tract looks like this:

• suddenly the person stops talking, laughing, screaming or crying, grabs his throat with his hands;
• there is a strong cough, the victim stops answering questions;
• when the victim tries to inhale, either wheezing is heard, or nothing is heard; the victim opens his mouth wide, but cannot inhale;
• the face, initially reddening, quickly becomes pale, and then acquires a bluish color, especially in the region of the upper lip);
• within a few tens of seconds, there is a loss of consciousness due to respiratory arrest;
• in a very short time, the work of the heart stops and clinical death occurs.

First aid for foreign bodies in the respiratory tract

A person who knows how to recognize this pathology will not waste a second. The situation is developing rapidly and delaying first aid can cost the victim his life.

The algorithm of actions for this pathology is as follows:

1. Address the victim with the question “What happened?” You may look stupid, but in reality this question is needed in order to understand whether a person is breathing at least somehow. Your further tactics will depend on this.
2. If a person is somehow breathing, encourage him with the words “Cough, harder, more, come on” - any words that “break through” to his consciousness. Often this is enough for a small foreign body that has entered the upper respiratory tract to come out on its own.
3. If spontaneous release of IT did not occur within 30 seconds, or if the person did not breathe from the very beginning, then the Heimlich maneuver should be applied.

Heimlich maneuver

The technique for doing it is as follows:

• Stand behind the victim.
• Grasp his torso with both hands, cover the fist of the right hand with the palm of the left hand, and use the knuckle of the thumb of the right hand to press five hard pressures on the upper abdomen. The direction is up and towards you. Restoration of breathing is a sign of removal of a foreign body from their airways.

Note: The Heimlich maneuver should be performed until the FB leaves the airway or until the person is unconscious. In the latter case, attempts to remove the foreign body should be stopped, and instead start.

Features of the Heimlich maneuver in children and pregnant women

When removing a foreign body in the respiratory tract in children under 1 year old, the rescuer should sit down, put the child on the left forearm face down, holding the lower jaw of the baby with fingers folded into a “claw”. The head of the child should be below the level of the body. After that, five medium-strength blows should be applied with the base of the palm to the interscapular region of the back. The second stage - the child turns face up on the right forearm, after the forehead, the rescuer makes five jerky movements along the sternum to a point located 1 finger below the inter-nipple line. Don't push too hard to break the ribs.

If a foreign body has appeared in the oropharynx, it is visible and can be removed without the danger of pushing it back - it is removed. If not, the whole cycle is repeated either until IT appears, or until cardiac arrest, after which cardiopulmonary resuscitation should be started.

In children aged 1-8 years, the Heimlich maneuver is performed by placing the child on the rescuer's thigh. The rest of the actions are performed according to the general rules.

You will receive more detailed information about emergency care for a child when a foreign body enters the respiratory tract by watching a video review by a pediatrician, Dr. Komarovsky:

An important question: “What if a pregnant woman was injured?” Indeed, pressing on the stomach of a woman who is at a long pregnancy is guaranteed to lead to serious complications. In this case, pressing is done not on the stomach, but on the lower part of the sternum, as in infants.

Common Mistakes in Airway Foreign Body Removal

The first thing that comes to mind when a foreign body enters the respiratory tract is to knock on the back. The correct algorithm for how to knock is described above. However, most of us just pound on the back with all our might. The danger of this method is that gravity acts on any foreign body. Incorrect tapping may cause IT to penetrate lower into the tracheobronchial tree and may cause complete airway obstruction. First aid in this case is to carry out a tracheotomy, and even if by some miracle a qualified specialist turns out to be nearby, the chance of saving the victim will become scanty.

Never turn your baby upside down to shake him. Spasm of the larynx reduces your attempts to remove a foreign body to zero. Instead, you can dislocate the baby's cervical vertebrae. The fact is that when a child loses consciousness, the tone of the muscles of the neck drops, while shaking, his head begins to dangle in all directions, which can lead to dislocation of the cervical vertebrae and even their fracture. Saving a baby from death, you risk making him disabled or even killed.

Situations in which a foreign body can enter the respiratory tract are not uncommon. Active communication and laughter during meals, hasty absorption of food with poor chewing, alcohol intoxication are the most common causes of such cases in adults.

But even more often cases of foreign objects entering the respiratory tract occur with children (more than 90%). They like to take small objects in their mouths, spin around, talk, laugh and play while eating.

Sometimes it is enough for the victim to cough quickly enough to clear the airways. But if the coughing fits continue, the person begins to grab his throat, cannot breathe, his face, which at first turned red, begins to turn pale, and then turn blue - emergency care is required. Delay threatens his life and health. It is necessary to immediately call an ambulance and take urgent measures to free the airways before the arrival of doctors.

Removal of a foreign body from the respiratory tract using the Heimlich maneuver

In children

Signs: The victim is suffocating, unable to speak, suddenly becomes bluish, may lose consciousness. Often children inhale parts of toys, nuts, sweets.

In adults

In pregnant women or obese victims (it is impossible or impossible to give thrusts to the abdomen).

If the victim has lost consciousness, call an ambulance and proceed with cardiopulmonary resuscitation. It is carried out only on a hard surface.

Continue resuscitation until medical personnel arrive or until spontaneous breathing is restored.

After restoring breathing, give the victim a stable lateral position. Ensure constant breath control until the arrival of an ambulance!

Everyone knows that it is better to prevent injuries or diseases than to be treated later and suffer from their consequences. To avoid getting into the respiratory tract of foreign bodies does not require much effort. It is enough to follow a few simple rules:

• do not rush to eat and chew food thoroughly;
• while eating, do not be distracted by conversations, disputes and showdown - violent emotions, laughter and sudden movements with a full mouth can end with Heimlich techniques;
• do not eat lying down, on the go on the street, in transport, especially while driving;
• to wean children and not to keep foreign objects in their mouths: pen caps, coins, buttons, batteries, and the like.

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An object is stuck in the throat - we will pull out a foreign body

Removal of a foreign body from the throat

• Child stuck something up his nose
• Inhalation of a living organism
• Complication after surgery
• Choking while eating
• After a nose injury

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Symptoms of a foreign body in the throat

Sore throat, pain when swallowing

It is the most common symptom for any type of foreign body and its localization. Sharp objects are characterized by a pronounced pain syndrome, which is aggravated by talking, swallowing and even breathing.

Foreign body sensation

The presence of a foreign body is always accompanied by discomfort. It can be a sore throat, cough, difficulty swallowing, increased salivation, vomiting, if the object is stuck in the oropharynx.

Respiratory failure

Large foreign bodies located above the entrance to the larynx or esophagus can partially block the lumen of the larynx, leading to respiratory failure. The cause of asphyxia (suffocation) is more often elastic foreign bodies of the pharynx.

What to do if a foreign body in the nose of a child

1. Making an appointment	2. Computed tomography	3. Endoscopic examination
4. Extraction of a foreign body	5. Additional treatment according to indications	6. Control inspection

Frequently asked Questions

What complications can occur when an object gets stuck in the throat?

The development of inflammation with increased pain and the occurrence of edema, difficulty breathing and swallowing. Sharp objects can cause significant damage to the tissues of the pharynx and, as a result, lead to bleeding. If an infection has joined, then an abscess of the pharynx and phlegmon of the neck will develop.

How does an ENT doctor remove a foreign body from the throat?

An otorhinolaryngologist removes an object using endoscopic equipment in adults with local anesthesia, in very young children - under general anesthesia. Sometimes surgery is required.

What to do first if something is stuck in the throat?

Rules for self-help if you choke: 1. Squeeze one hand into a fist and the side where the thumb is, put it on the stomach at a level between the navel and costal arches. 2.

The palm of the other hand is placed on top of the fist, with a quick upward push, the fist is pressed into the stomach. 3. Repeat several times until the airways are clear.

You can also lean on a firmly standing horizontal object (table corner, chair, railing) and push upward in the epigastric region.

To prevent a foreign body from getting into the throat, you need to: do not keep small objects in your mouth, do not talk while eating, do not abuse alcoholic beverages, do not leave children unattended and buy toys that match the age of the child, take proper care of bedridden patients or relatives after a stroke, in case of violation of the act of swallowing.	After removing a foreign body from the throat of an adult or a child, the ENT doctor, as a rule, prescribes additional anti-inflammatory therapy, depending on the severity of the damage to the pharyngeal mucosa by the object.
If you managed to get a foreign body out of the throat on your own, especially if it has sharp corners (edges), consult an ENT doctor for examination to rule out damage to the throat mucosa or remaining fragments of the foreign body.	If you or your child experience discomfort, pain, purulent discharge, bad breath after removal of a foreign body from the throat, consult a doctor.

Advantages of the Garant clinic

Equipment Karl Storz MC Garant uses Karl Storz manipulation and visual endoscopic equipment. Using the power and high quality optics of endoscopes, the doctor can better see what is happening inside the nose. He will be able to locate the item and retrieve it.

Interdisciplinary approach Computed tomography is used in cases where it was not possible to detect a foreign object in the nose with an endoscope (for example, due to severe inflammation). According to the tomography, the doctor will determine exactly where the foreign body is located and how damaged the tissues of the nose are.

Minimally invasive operations With indications for surgical removal of the object, the procedure is performed in an operating room equipped with the necessary equipment, according to the FESS method, in which access is through natural openings and mini-incisions that do not leave visible scars.

Prices: the cost of removing a foreign body from the throat in Yekaterinburg. There is a loan and installment

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Removal of a foreign body from the throat (pharynx) must be carried out until edema and inflammation have developed, which will interfere with its extraction, therefore, sign up with the Guarantor as soon as possible.

Diagnosis and extraction of a foreign body from the throat is carried out in 15 to 60 minutes, if there are no complicating factors.

Foreign bodies of ENT organs

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External auditory canal

Various foreign objects are most often removed from the external auditory canal in children who put all kinds of things in there: seeds, beads, cogs, fruit pits, peas, small parts of the designer, etc.

In adults, foreign bodies enter the ears, usually as a result of trauma or poor hygiene.

Also, they often turn to the ENT after outdoor recreation - after all, insects crawling into the external auditory canal also belong to foreign bodies.

Diagnosis of a foreign body

Diagnosis is put on the basis of a patient interview and examination of the ear canal.

To determine further tactics treatment, first of all, it is necessary to establish the type of foreign body: is it alive, does it have sharp edges, can it swell from liquid, have attempts been made to remove it on their own and has the patient suffered from any ear diseases before - all this helps to prevent development complications.

Foreign body extraction methods (performed by a qualified doctor).

1. Washing with warm water. For this, a 100-150 ml syringe is used. If the foreign body is swellable (peas or beans), warm alcohol-based drops are first poured in, due to which the legumes "shrink", as well as liquid oil, due to which the body can slip out.
2. If an insect gets into the ear, then oil is poured into the passage - the insect will die and stop causing discomfort and pain to the patient.
3. If the eardrum has a perforation (this happens if the patient has previously undergone some types of treatment for ear diseases), then washing is contraindicated. It also does not make sense to flush the passage if the foreign body completely blocks it, since water cannot penetrate through it and, accordingly, wash it out.
4. If washing does not help, then either a blunt hook is used, which winds up behind the foreign body and pushes it to the exit, or a sharp one, which pierces it and pulls it out.

If the manipulations are painful (especially in children), short-term anesthesia is sometimes used for their implementation.

Most often, foreign bodies in the nose fall to children. Usually these are various small items - buttons, coins, pebbles, etc.

If a foreign body is present in the nasal cavity recently, then the patient is usually worried about shortness of breath on one side. With a long stay in the nasal cavity, the appearance of fetid discharge from the nose is added to one-sided breathing.

If a foreign body has entered the nose recently, then its extraction does not require complex manipulations. Sometimes it’s enough just to blow your nose, if that doesn’t help, vasoconstrictor drops are used and the object is removed with a tool. After removing the foreign body, the symptoms gradually resolve themselves.

Pharynx

Most often, doctors are contacted when fish bones or fragments of meat bones get into the throat. Other objects also most often penetrate the pharynx in the process of eating. At risk are people with missing teeth or with an installed denture, due to which the control of the soft palate is turned off.

• Also, a common reason for foreign bodies to enter this area is hasty eating, poor-quality chewing of food, the habit of holding a pen or other accessories in the mouth while working.
• Cases of foreign objects getting into the throat are classified according to the place of localization:

1. in the nasopharynx;
2. in the oropharynx;
3. in the throat.

Small or sharp objects (fish bones, fragments of meat bones, glass) usually get stuck in the oropharynx. Large foreign bodies get stuck in the laryngopharynx: pieces of unchewed food, large bones, coins (usually in children).

Foreign objects enter the nasopharynx in rare cases.

Symptoms

In the oral part - stabbing localized pains, especially pronounced with an empty throat. Due to abrasions and scratches, the patient may experience pain for some time even after removal of the foreign body. There is also a feeling of an obstacle in the area where a foreign object is located.

Diagnostics

Oropharynx: in this zone, a foreign body can be detected during examination - hemorrhages and a violation of the integrity of the mucosa indicate the presence of a problem. When the fragments are deeply immersed in the tissues of the tonsils, they can be detected by palpation.

Laryngopharynx: in this area, foreign bodies are detected using laryngoscopy.

If it was not possible to identify the body by indirect laryngoscopy, direct hypopharyngoscopy is used. Metal objects are detected by fluoroscopy.

Removal

To remove a foreign object, it must be seen. Carrying out blind manipulations and "pushing" objects further are contraindicated. In the oropharynx, objects are removed with tweezers. Removal of objects from the larynx is carried out under anesthesia with the help of special laryngeal forceps and a mirror.

Independent attempts to remove a foreign object can lead to a worsening of the situation! It is better to trust a specialist.

1. Article author
2. Padalka Anastasia Yurievna,
3. ENT doctor of MC "AVENUE-Bataysk".

Padalka A.Yu. Nikanorov V.Yu. Radchenko L.V. Tsai L.A. Bykova V.V. Goncharova O.V. Back

Foreign body of the pharynx

In modern ENT practice, such a phenomenon as a foreign body in the throat occurs quite often, and children and adolescents are more susceptible to it, less often pensioners and adults. As you know, a foreign body is a foreign household item that accidentally or through negligence got into the respiratory system and got stuck there.

If the characteristic problem is not solved in a timely manner, an extremely undesirable obturation of the upper respiratory tract occurs with the development of asphyxia. Accordingly, such a condition may already end in an unexpected fatal outcome, which should never be allowed.

As you know, the pharynx in such a clinical picture performs a protective function, that is, when a foreign object penetrates, it demonstrates its contractility and, thereby, prevents its penetration deeper into the digestive system. However, this does not mean at all that the problem is completely absent, therefore, it is necessary to immediately take a number of therapeutic and resuscitation measures to immediately stabilize the general condition of the patient.

If we talk about the etiology of a characteristic pathological process, then it is worth noting that such penetration is preceded by a number of pathogenic factors:

1. imprudence and inattention of parents who leave children's amusements without due attention;
2. distraction of pensioners, which is complemented by poor eyesight and impaired coordination of movements;
3. teenage experiments with their health;
4. poor-quality cooked food;
5. harmful production;
6. poorly performed medical procedures, as an option - by a dentist.

All foreign bodies that, for one reason or another, penetrate the pharynx can be conditionally classified into the following varieties:

1. live (poorly cooked food, berry bones, fish bones, large pieces of meat, shells, scales);
2. organic (teeth or dentures);
3. inorganic (buttons, small parts, badges);
4. metal (studs, bolts, screws, fragments and fragments of medical instruments).

The therapeutic effect, as well as the success of the resuscitation measures, depends on this characteristic. That is why it is so important to know what kind of object was swallowed, and not to put off going to a specialist.

The first thing to focus on is an unpleasant sore throat, accompanied by a feeling of a foreign body that prevents normal breathing and swallowing.

As a rule, the pain syndrome becomes more intense precisely when swallowing, and in some clinical pictures it completely catches your breath, provoking an attack of dizziness.

If the feeling of lack of air progresses, then an unexpected death due to asphyxia is not ruled out.

If a foreign body was swallowed by a child, then it is possible that he will hide his act for a long time. So that such a children's secret does not end in tragedy, it is important to monitor his condition.

To do this, pay attention to passivity, lack of appetite, impaired salivation, regular urge to vomit and unpleasant grimaces during swallowing.

If characteristic anomalies are present, it's time to talk heart to heart with your child.

When the essence of the problem becomes clear, detailed diagnostics should also not be delayed, otherwise delay in this matter may cost a human life.

In most clinical pictures, it is not difficult to make a final diagnosis, especially since most of the patients know exactly which foreign body and when it entered the body. In such cases, additional diagnosis is not required at all, and it is important to start treatment immediately.

If the anxious parents find it difficult to answer what their child swallowed, and the young patient himself is silent, like a partisan, the doctor prescribes a clinical examination to determine the foreign body, its structure and nature, as well as the focus of localization in the digestive organs.

Among the most effective diagnostic methods, the following should be highlighted:

1. pharyngoscopy to visualize a foreign body;
2. radiography to determine the focus of pathology;
3. laryngoscopy, rhinoscopy, esophagoscopy are appropriate only in those clinical pictures where a foreign body wanders through the digestive organs.

Sometimes it happens that the patient complains about the presence of a foreign body in the throat, but after a thorough examination, the doctor does not detect such a thing in a characteristic area. But the injury to the pharynx is obvious, indicating an attempt at self-treatment. If such an item has already been swallowed, then the consequences of such an “inedible meal” are the most unpredictable.

As a rule, such measures are quite enough to make a final diagnosis, however, the doctor must be able to differentiate the characteristic ailment with maximum accuracy during palpation and study of the examination results.

It is possible to prevent this disease, but this requires increased vigilance for patients at risk. In the case of children's organisms, it is forbidden to take small parts into the mouth, and even purchase toys according to the prevailing age. If it is obvious that the child is very active. Then do not lower your close attention from him during the day.

Adult patients and pensioners with reduced vision are advised to wear glasses, be especially picky about food, and be vigilant about wearing dentures. All these actions help to prevent the penetration of foreign bodies into the body with a further exacerbation of the inflammatory process.

If the problem nevertheless occurred, then it is impossible to use sharp objects, tweezers and forceps to remove a foreign object from the throat, since one inept movement can damage the mucous membrane of the throat. Timely appeal to the ENT allows many patients to prolong their own lives and not become a victim of asphyxia.

So, if a foreign body is present in the pharynx, then it can only be removed surgically. Superficial self-treatment in this matter is inappropriate, so it is extremely important to seek qualified help from an otolaryngologist.

If the foreign object has penetrated shallowly, then the ENT can remove it already during a visual examination without additional hospitalization.

For these purposes, special medical devices such as tweezers, Brünings forceps or nasal forceps are used.

After carrying out this unpleasant procedure, the doctor lubricates the throat with a special Lugol solution, and for the first days recommends eating exclusively liquid food.

If the foreign body has penetrated deep into the esophagus, then surgical procedures are required, performed under local anesthesia. The process uses a laryngeal speculum and forceps, and releases the esophagus using laryngoscopy.

Opening the pharynx is required in exceptional cases, and this procedure has received the name pharyngotomy, which is carried out strictly according to indications and based on detailed diagnostics.

For the most part, the clinical outcome is quite favorable, and the patient becomes much easier to breathe when providing immediate assistance.

It is forbidden to let the problem take its course, otherwise the aggravated asphyxia will end in mortality.

Foreign bodies of the pharynx

:

• Definition
• Causes
• Symptoms
• Diagnostics
• Prevention

Definition

Foreign bodies most often get stuck in the throat while eating. Foreign bodies of the pharynx usually get stuck in the pharyngeal or lingual tonsils or piriform sinus.

Causes

Usually, among foreign bodies, fish bones can be most often observed, occasionally there are meat bones. Sometimes when a person holds a needle or other sharp object in their mouth, it can move and get stuck in the throat.

More often, foreign bodies get stuck in the palatine tonsils, pear-shaped fossae, lingual tonsil and lateral surfaces of the root of the tongue. The deepening of foreign bodies in the pear-shaped fossa of the hypopharynx can be dangerous to human life, as phlegmon and sepsis can develop.

Symptoms

With foreign bodies in the pharynx, patients complain of stabbing pains that increase during swallowing. Patients clearly feel the deepening of the foreign body.

In addition, they show significant reflex salivation due to irritation of nerve endings and inflammatory changes in the places where the foreign body is deepened. Particularly significant salivation occurs when foreign bodies are deepened into the pear-shaped fossae of the laryngeal part of the pharynx. Large foreign bodies that get stuck in the lower pharynx can cause asphyxia.

In patients with prolonged immersion of foreign bodies in the pharynx, an inflammatory reaction occurs around the foreign body due to infection of this area. Further, the formation of phlegmon in the pharynx and parapharyngeal area with subcutaneous emphysema and the occurrence of a septic condition are possible. Cases of damage by a foreign body to the common carotid artery with a fatal outcome are described.

Diagnostics

When recognizing foreign bodies of the pharynx, attention should be paid to the fact that sometimes, despite the characteristic complaints of patients and the executive review of the pharynx, it is not possible to detect a foreign body. Then a digital examination of the pharynx should be used, in which a foreign body is clearly palpable.

To detect metal foreign bodies, it is advisable to use radiography in two projections, and even better - tomofluorography. It should be noted that non-metallic foreign bodies that have gone deep into the lateral parts of the pharynx and deeply penetrated into the lower part are difficult to recognize.

To identify foreign bodies, it is necessary to make an overview of the pharynx using a laryngeal mirror. It should be borne in mind that the presence of a foreign body in the lower pharynx is evidenced by foamy saliva, swelling of the mucous membrane and shortness of breath.

Often patients, more often neurasthenics, tell the doctor that they have a foreign body stuck in the throat a few months ago, and it moves either to the right, then to the left, or up and down. Such complaints rather indicate the absence of a foreign body.

Prevention

To remove foreign bodies from the middle sections of the pharynx and pharynx, you can use tweezers. If a foreign body is in the laryngeal part of the pharynx, it is removed with bent forceps under the control of a laryngoscope mirror. Before removing a foreign body from the lower parts of the pharynx, it is necessary to anesthetize the mucous membrane.

Leeches are removed from the pharynx after lubricating them with a concentrated solution of sodium chloride.

In the event of mediastinitis, it is advisable to do a cervical mediastinotomy, with parapharyngeal phlegmon - a wide and deep incision of the phlegmon from the side of the neck, followed by drainage.

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Specialization: Otorhinolaryngologist (ENT)

Foreign bodies of the pharynx - symptoms, diagnosis, removal

Foreign bodies of the pharynx are living organisms, parts of food or foreign objects that have accidentally entered the pharynx and have a damaging effect on its mucosa.

Foreign bodies in the pharynx can lead to obstruction of the upper respiratory tract with subsequent development of asphyxia and cause infection.

Causes of a foreign body entering the throat

The most common cause of foreign objects entering the throat is talking and laughing while eating, as well as inattention in the process of eating.

Foreign bodies in the pharynx are classified by their nature as follows: living, iatrogenic, food and household. Most often, foreign bodies are found, which are parts of food: poorly chewed pieces of meat, meat and fish bones.

The group of household foreign bodies includes: small toys and their parts, pieces of wood or glass, coins, dentures, hairpins, buttons, sewing needles, screws, nails.

Among the iatrogenic foreign bodies, there are: fragments of medical needles, dental drills, cotton swabs and other instruments that are used in surgery, otolaryngology and dentistry.

Causes of foreign bodies in the throat

Ingress of foreign objects into the pharynx is possible during tonsillectomy, adenotomy, when removing benign tumors of the nasal cavity and pharynx, during prosthetics, caries treatment, and tooth extraction.

By origin, foreign bodies of the pharynx are divided into:

• endogenous, which enter the pharynx in an ascending way or are formed directly in it;
• exogenous foreign bodies penetrate the pharynx from the outside through the nose or mouth.

According to the depth of penetration, foreign bodies are divided into superficial and deep-penetrating pharynx tissues.

Symptoms of foreign bodies of the pharynx

The clinical picture of this condition is determined by the shape, type, size and location of foreign bodies in the pharynx, as well as the time of entry into it. Common symptoms are: increased salivation, difficulty swallowing, coughing, itching, feeling of a foreign body, sore throat.

In some cases, the pain may radiate to the larynx or ear. If a foreign body is localized in the oropharynx, then there is an urge to vomit. Sometimes an object that has fallen into the throat passes into the larynx or esophagus, damaging the pharyngeal mucosa on its way and causing pain and soreness in the throat.

Diagnosis of foreign bodies of the pharynx

Foreign bodies located in the oropharynx are diagnosed, as a rule, without difficulty. For better visualization, pharyngoscopy and X-ray examination are used.

Removal of foreign bodies of the pharynx

Removal of foreign objects from the pharynx is performed using Brunings forceps, tweezers or nasal forceps. After this procedure, the pharynx is treated with a special solution, and the patient is prescribed rinsing with antiseptic solutions and eating soft food.

Foreign bodies in the nasopharynx and their removal

If you put together different objects that otolaryngologists extract from noses, larynxes and other ENT organs, you get a very entertaining collection. At the same time, keep in mind that their patients are not always children, as most people believe.

A variety of small objects can enter the respiratory tract: bones, seeds, pieces of food, small parts from toys, beads, coins, pins, nails and much more.

Foreign body can enter the nasopharynx different ways. Most often - through the mouth, much less often - through the nose, trachea, larynx.

Most often, various small bones (fish, meat, and others) get stuck in the oropharynx.

The main causes of foreign bodies entering the nasopharynx

Haste while eating. Decreased sensitivity in people with dentures. Occupational habit of holding various small objects in the mouth, such as nails, pins, needles, etc.

Small children often put various small objects into their noses (coins, buttons, bones, beads, small parts of toys, etc.).

Usually these objects get stuck in the common or lower nasal passage.

Symptoms of a foreign body in the nasopharynx

To the characteristic signs of the presence foreign body in the nose include:

Nasal breathing is unilateral and labored; - purulent discharge comes from one of the halves of the nose;

Sometimes nosebleeds are observed.

Symptoms of a foreign body in the throat are:

Difficulty swallowing; - pain during swallowing; - stabbing pain, aggravated during swallowing;

- large foreign bodies in the throat may cause shortness of breath.

Symptoms of foreign bodies entering the respiratory tract:

Feeling of discomfort; - sensation of movement of an object in the airways; - shortness of breath;

Knowing these symptoms is especially helpful if you have young children, as toddlers are not always able to explain what has happened.

Removal of foreign bodies from the nasopharynx

Finding the presence of a foreign body in the nasopharynx, do not try to get rid of it yourself, especially by blindly pushing the object. This is dangerous and can only worsen the situation. Extraction of foreign bodies from the nasopharynx must be carried out by an experienced physician.

Seek help at removal of foreign bodies from the nasopharynx to our clinic! At your service modern equipment and many years of experience of our doctors.

In our clinic we removal of foreign bodies from the nasopharynx quickly and painlessly, thanks to the professionalism of our doctors and the use of effective local anesthesia.

If there is foreign bodies in the nasopharynx do not postpone a visit to the doctor, this can lead to unpleasant consequences. And remember that extraction of foreign bodies from the nasopharynx should only be carried out by a highly qualified specialist!

Foreign bodies of the pharynx

In modern ENT practice, foreign bodies of the pharynx are quite common. They can be of the most diverse nature and form: cereal shells, pieces of fruit, fish bones, pieces of wood, metal objects, dentures, etc. As a result of wearing dentures, the sensitivity of the mucous membrane of the soft and hard palate is significantly reduced, so foreign bodies can get into throat is invisible.

Depending on the size and shape, foreign bodies of the pharynx can get stuck between the tonsil and the palatine arch, in the lacunae of the palatine tonsils, and sometimes penetrate into the thickness of the tissue (especially the tonsils).

There are also cases when a foreign body gets stuck in the region of the lingual tonsil, in the piriform sinus, in the lateral ridge, in the vallecule.

It is possible to get into the throat and live foreign bodies: insects, beetles, leeches (when drinking water or swimming in a natural reservoir)

Symptoms

Symptoms depend on the site of introduction, the shape and size of the foreign body in the pharynx. The main symptoms include: a feeling of the presence of a foreign object in the throat, aggravated by swallowing, stabbing pain in the throat, sore throat, cough, and salivation may occur.

If the foreign body is large enough, breathing becomes difficult, speech is disturbed, and asphyxia may occur.

If a foreign body has been in the pharynx for a sufficiently long period of time, inflammation of the soft tissues, sepsis and bleeding may occur at the site of its introduction.

The final diagnosis is established on the basis of a visual examination of the pharynx. In some controversial cases, X-ray examination is performed

Treatment

Treatment consists of removing the foreign body from the pharynx with tweezers, clamps, and laryngeal forceps. In some cases, pear-shaped pockets, mucous membranes are preliminarily anesthetized. the back wall of the pharynx and the root of the tongue with a 10% lidocaine solution.

If, after removal of a foreign body, a wound surface remains at the site of its introduction, this area is lubricated with a 5% solution of iodine (Lugol's solution), followed by rinsing the throat with a weak solution of potassium permanganate or a solution of furacilin.

For five to seven days, it is forbidden to take coarse food that can cause irritation.

More articles on this topic:

1. Diaphragm of the larynx 2. Retropharyngeal abscess

Extraction of a foreign body from the laryngopharynx

There are exogenous and endogenous foreign bodies of the laryngopharynx. The first group is foreign bodies that have entered the throat from the outside. They are the most common.

The second group consists of foreign bodies that form in the pharynx itself. These include tonsil stones, which are very rare.

Foreign bodies often enter the throat with food (fish and meat bones, glass fragments, pieces of wire and wood, pieces of meat, cereal grains, etc.)

Foreign bodies can also be objects that accidentally get into the mouth (nails, buttons, pins, sewing and medical needles, hooks, small parts of toys), as well as dentures.

Live foreign bodies are also observed.

In countries with a hot climate, and in our country in the republics of Central Asia and Transcaucasia, there are leeches that can penetrate into the oral cavity when drinking water from a stream, ditches, while bathing.

In the oropharynx, sharp and small foreign bodies (often fish bones) usually get stuck, penetrating into the lacunae of the palatine tonsils, the arches, the lingual tonsil, and the valleculae.

Large foreign bodies (buttons, coins, pieces of unchewed food, dentures, large meat bones) stop in the laryngopharynx above the entrance to the esophagus or in the pear-shaped pocket. Foreign bodies in the nasopharynx are much less common.

They get into it with injuries of the nose and paranasal sinuses, vomiting, during medical procedures, as well as when trying to remove a foreign body from the lower pharynx.

Symptoms of a foreign body in the laryngopharynx

Clinical symptoms due to the presence of a foreign body in the laryngopharynx depend on its size, shape, site of introduction and duration of stay. The main symptoms are sore throat, aggravated by swallowing, sensation of a foreign object. Difficulty in swallowing food, salivation are noted. Large foreign bodies stuck in the lower part of the pharynx disrupt speech, cause coughing and severe shortness of breath.

At the location of the foreign body in the wall of the pharynx, an inflammatory process occurs, as a result of which pain intensifies. Often a foreign body that has passed into the esophagus and stomach injures the mucous membrane of the pharynx, which can cause symptoms of an "imaginary" foreign body.

The sensation of a foreign body may be associated with chronic inflammatory processes and tumors of the pharynx, paresthesia, lengthening of the styloid process, deforming spondylosis of the cervical spine, osteophytes of the cervical vertebrae, and pharyngeal-esophageal-cervical syndrome.

The special suspiciousness of the patient also matters.

Complications of a foreign body of the laryngopharynx

A foreign body of the pharynx, injuring the mucous membrane and submucosal layer, can cause a number of complications: abscesses of the pharynx (retropharyngeal, lateropharyngeal) and tonsils, submandibular lymphadenitis, neck phlegmon, bleeding, subcutaneous emphysema. Perhaps the development of mediastinitis, sepsis, damage to the cervical vertebrae.

Diagnosis of a foreign body of the laryngopharynx

The diagnosis of a foreign body in the pharynx is established on the basis of the patient's complaints, anamnesis data and the results of objective studies: mesopharyngoscopy, posterior rhinoscopy, indirect and direct laryngoscopy.

The patient's indication of pain when swallowing in a certain place facilitates the identification of a foreign body.

Examination of the pharynx should be thorough, especially carefully you need to examine the places of the "favorite" localization of foreign bodies: palatine tonsils, arches, vallecules, pear-shaped pockets.

If there is a suspicion that the foreign body is in the palatine tonsil, it is necessary to slightly dislocate it, moving the anterior palatine-lingual arch with a spatula, and carefully examine the gaps. Inspection of the pharynx is best done under local terminal anesthesia. In the diagnosis of foreign bodies, especially metallic ones, it is advisable to conduct a survey radiography of the pharynx in two projections.

Removal of foreign bodies from the laryngopharynx is not particularly difficult.

From the oropharynx, a foreign body is usually removed during pharyngoscopy using nasal forceps with tightly touching branches, forceps, cranked or anatomical tweezers.

Our medical center employs an otorhinolaryngologist with extensive experience in the emergency department of a large emergency hospital in Moscow, please contact us for help.

Foreign body of the pharynx

One of the problems associated with the pharynx can be the ingress of foreign bodies into it: fish bones, pieces of meat, wood, wire or even glass.

Most often this is caused by haste during eating, missing teeth or problems with them, sudden coughing, laughing, and just talking while chewing. In addition, foreign bodies can enter the pharynx from the nose, larynx, or esophagus.

If the foreign body is large enough, it can cause suffocation due to poor air passage, and as a result, acute oxygen deficiency.

Symptoms caused by the ingress of foreign bodies into the throat can be different. It depends on what exactly got into the throat, the place of entry, the length of stay of the foreign body in the throat, the age of the victim and his individual reaction. But the main symptom of finding a foreign body in the throat is pain of varying degrees: from mild to severe.

With a long stay of a foreign body in the throat, an abscess of the pharynx (purulent inflammation), phlegmon (acute purulent inflammation that does not have clear boundaries) in the pharynx and neck, pharyngeal bleeding and even sepsis may develop - an inflammatory reaction of the body, accompanied by a purulent process. To prevent this, it is necessary to consult a doctor in time to remove a foreign body from the pharynx.

The procedure is carried out with tweezers, laryngeal forceps or other instruments. If this does not help, then you will have to perform a surgical intervention: a tracheotomy or a faster operation - a conicotomy, and only after that, in a calm environment, remove the foreign body from the pharynx.

Directory of ENT diseases

Foreign bodies of the pharynx

Foreign bodies of the pharynx often get along with food (fish and meat bones, glass fragments, pieces of wire, pieces of meat, fat). Foreign bodies can also be objects accidentally caught in the mouth (pins, nails, buttons), dentures. Less common are living foreign bodies (leeches, roundworms). hit foreign bodies in the throat may be due to such predisposing moments as fast food, sudden laughter or coughing during meals, missing teeth or the presence of dentures, the habit of holding small objects in the mouth. In the oropharynx, sharp and small foreign bodies usually get stuck, penetrating into the palatine tonsils, arches, and the root of the tongue.

Foreign bodies large sizes stop in the laryngopharynx (above the entrance to the esophagus or in the pear-shaped pocket). Much less often, foreign bodies enter the nasopharynx (with injuries of the nose and paranasal sinuses, vomiting).

Clinical picture

Symptoms depend on size foreign body, its forms, places of implementation. The main symptoms: sore throat, aggravated by swallowing, sensation of a foreign object in the throat, difficulty in swallowing food, salivation.

Large foreign bodies stuck in the lower part of the pharynx disrupt speech, cause coughing and severe difficulty in breathing, asphyxia is possible.

At the site of the introduction of a foreign body into the pharyngeal wall, inflammation occurs, which increases pain.

With a long stay in the pharynx of a foreign body, complications are possible in the form of abscesses of the pharynx, phlegmon or sepsis, bleeding.

Often a foreign body that has already passed into the stomach injures the mucous membrane of the pharynx, which causes symptoms of an imaginary foreign body.

The sensation of a foreign body may be associated with chronic inflammatory processes and tumors of the pharynx, paresthesia, and excessive suspiciousness of the patient.

Urgent care

Emergency: Removal foreign body of the pharynx produced in the otorhinolaryngological office (department). In case of asphyxia, one should try to remove the foreign body with a finger; in case of failure, a tracheostomy is necessary.

Foreign object in the throat

The sensation of a foreign body in the throat may appear directly in the process of eating. In this case, the cause is most likely to be a piece of food stuck in the throat.

Dry or poorly chewed food can get stuck in the throat. Also, the use of fruits and vegetables with a peel, seeds, fish with a large number of small bones increases the likelihood of a feeling that a foreign body is stuck in the throat. In this case, often as concomitant symptoms occurs:

• coughing;
• sore throat;
• pain in the nasopharynx;
• nausea and vomiting.

In such situations, it is advisable to use viscous products, such as yogurt or kefir. A stuck bone can also interfere in the throat and cause discomfort, in which case tweezers are used to remove it.

Most often in childhood there are cases of swallowing various objects. Children taste everything, so small toys, household items, medicines, and the like can get stuck in a child's throat.

However, even in adults, the feeling that something is stuck in the throat can be caused by swallowing, for example, pins or needles, which seamstresses often hold with their lips.

If something like this got into the throat, you can try to remove the foreign object yourself, if it doesn’t work out, consult a doctor. It is impossible to delay with medical help if:

• an object caught in the throat makes it difficult to breathe;
• a needle or sharp pin is stuck in the throat;
• a toxic object, such as a battery or a tablet, has entered the throat;
• a pair or more magnets act as a foreign object.

Among the most common causes of feeling like something is stuck is vomiting. Small pieces of food, as well as irritation of the pharyngeal mucosa by the acidic environment contained in the stomach, often cause a feeling that something is stuck in the throat. In this case, a little drunk liquid, as well as gargling with a soda solution, quickly relieves an unpleasant symptom.

Swallowing pills is often a problem for many people. In this case, the feeling that something is stuck in the throat occurs due to:

• insufficient amount of liquid to swallow the tablet;
• too large size of the drug;
• nervousness and fear of the process of swallowing.

Sometimes the tablet or capsule is so large that the person experiences fear when swallowed, thereby causing a spasm of the nasopharyngeal muscles and further exacerbating the situation.

Important! The drug can get stuck in the larynx when the pharynx is not sufficiently moistened or the tablet was swallowed without water.

Therefore, even in the instructions for many drugs, you can find recommendations for their use.

So, some tablets need to be swallowed whole, while others are allowed to be pre-divided into pieces, chewed or crushed into powder.

In order to get rid of an unpleasant symptom in this case, you must try to push the pill further down the esophagus, washing it down with plenty of liquid.

Causes of the sensation of a foreign object

Often the presence of a foreign object is illusory. A person feels that something is stuck in the throat, while in reality there are no foreign objects in the throat. Among the main reasons that cause a feeling of a foreign body are:

• viral and bacterial infections of the nasopharynx;
• allergic reactions;
• problems in the digestive system;
• pathology of the spine, especially the cervical region;
• thyroid problems;
• neurological disorders;
• excess weight;
• vegetovascular dystonia;
• complications after taking medications.

A common infectious disease can cause a feeling of a foreign object. Often, with diseases of the nasopharynx, an inflammatory process occurs, accompanied by swelling of the throat mucosa, purulent plaque, which causes a feeling of constriction.

The palatine tonsils can enlarge as a result of frequent illnesses or against the background of chronic diseases, which also causes a sensation of a foreign object, as well as difficulties in swallowing food and saliva.

Allergic reactions can cause burning and soreness in the throat, which often gives the impression of the presence of a foreign body.

The feeling that something is stuck in the throat can also occur as a result of psycho-emotional overload, as a result of stress, nervous experiences, depression, fears and increased anxiety.

At the same time, an unpleasant feeling appears and disappears spontaneously. At the same time, a feeling of constriction and pain may not affect the entire throat, but be localized, for example, only on the right or left.

The symptom disappears after complete calm, while the feeling does not go away even after drinking a lot of water and gargling.

If, after a strong nervous shock, a person experiences a feeling of a foreign object in the throat, it is necessary to seek help from a neurologist.

Problems with the digestive system can also cause tightness in the throat. In this case, the pathology may be accompanied by:

• burning sensation in the esophagus;
• belching;
• pain in the stomach;
• indigestion.

If the sensation of a foreign object in the throat is accompanied by these symptoms, then most often the patient is diagnosed with a hernia, gastroesophageal reflux, and esophageal pathology.

Sometimes, on the contrary, diagnostic procedures, such as endoscopic examination, can cause microtrauma due to which there is a tightness in the throat.

In this case, no treatment is required, healing occurs without outside help.

Cancer tumors that affect the larynx, pharynx, or esophagus cause discomfort in the pharynx, causing pain, itching, and a feeling of a foreign object. The patient has difficulty swallowing. For help in this case, you need to contact an oncologist.

Important! Some blood pressure medications, antiallergic drugs, and other medications can cause a feeling of a foreign object in the throat.

Diagnosis and treatment

In order to establish the true cause that caused the feeling of tightness in the throat, it is necessary to consult a therapist.

After the examination, the doctor can make a diagnosis, but consultation with other specialists is often required, for example, a neurologist, oncologist, surgeon, gastroenterologist, endocrinologist, and others.

In addition to a general examination, it is often necessary to carry out a number of additional diagnostic procedures:

• pass a clinical analysis of blood and urine, an analysis of hormones;
• ultrasound examination of the thyroid gland and esophagus;
• radiography, magnetic resonance and computed tomography of the cervical vertebrae.

Only after a thorough examination, the doctor will be able to make the correct diagnosis and prescribe effective treatment.

What to do to help a person get rid of the feeling of the presence of a foreign object in the throat? The correct solution is to eliminate the cause that caused the unpleasant symptom.

If infectious diseases are the cause of the unpleasant feeling, then medical treatment should be started immediately, aimed at combating the virus that caused the disease. In the case of bacterial infections, complex treatment is prescribed using:

• antibiotics;
• drugs to reduce fever, usually based on ibuprofen or paracetamol;
• rinsing with antiseptic agents: furatsilina solution, soda-salt solution, chamomile decoction.

Treatment of neurological disorders is based on:

• normalization of sleep and wakefulness;
• elimination of situations that provoke stress;
• drug therapy using antidepressants.

If problems are identified in the work of the thyroid gland, a feeling of tightness in the throat may be due to a lack of iodine in the body. In this case, hormone therapy is used to normalize the work of the gland, as well as iodine preparations to make up for its lack.

Osteochondrosis of the cervical spine also requires medical treatment, but usually therapy is not limited to this. This is the case when the patient needs to carry out a number of additional procedures, for example, acupuncture, massage.

If the patient experiences an illusory sensation of the presence of a foreign body in the throat, only the elimination of the cause that caused it can remove the symptom. However, if you can’t stand it at all, you can use distracting procedures, such as rinsing with decoctions of medicinal herbs (chamomile, calendula), warm drinking (mint tea, motherwort decoction), irrigation of the throat with antiseptic sprays.

• Hope Chernobay

Foreign body in the throat in children, symptoms, what to do?

Young children have a dangerous habit of holding large objects in their mouths: various balls (glass or plastic), pebbles, parts from collapsible toys, etc.

These items, accidentally swallowed, can get stuck in the lower part of the oropharynx and interfere with breathing - up to suffocation.

Large candy canes, pieces of lumpy sugar, pieces of food (for example, a piece of cracker or biscuit, an unchewed piece of meat), etc., can act as a foreign body.

As foreign bodies of the pharynx, fish bones that are stuck in the mucous membrane lining the pharynx are considered.

When a large foreign body enters the throat, a characteristic clinical picture occurs: breathing is disturbed to some extent, suffocation may occur (the child quickly turns blue, loses consciousness; his pulse slows down, blood pressure drops). When a fish bone is stuck in the mucous membrane of the pharynx, the child complains of a sensation of a foreign body in the throat, difficulty in swallowing, and pain in the throat; when swallowing food, the pain in the throat increases.

Symptoms of foreign bodies

If a child chokes on a foreign object, first of all try to calm him down and assess the condition. With normal breathing, he can clear his throat on his own. If you notice that he is suffocating, losing consciousness, his skin turns blue, emergency help is needed.

A foreign body in the nose is not uncommon in young children, in the process of playing they often take small objects in their mouths or try to sniff them. The baby himself may not notice how he inhaled a small part of the toy, but you should be attentive to him, to toys and remember this possibility.

Usually, a foreign body blocks one nasal passage and the child's breathing is preserved, although it is difficult. The child may be disturbed by the feeling of something foreign in the nose.

He starts to worry, opens his mouth to take in more air. After a few hours, light, abundant discharge from the nose appears, which quickly acquires the character of bloody. Distinctive features of traumatic rhinitis are the absence of signs of infection before its appearance, unilateral lesion, the absence of systemic manifestations of the disease and intoxication.

A child suffering from a foreign body in the throat should be helped:

• if a large object is stuck in the child's throat and this object is visible when he opens his mouth, you can try to get this object with your fingers. The object should be removed as soon as possible, since the life of the child depends on it in many cases;
• if the object cannot be removed with the fingers, the child should be turned upside down and tapped on his back (between the shoulder blades) with his palm - a cough reflex occurs. When coughing, a foreign body, carried away by a stream of air, is ejected from the lower part of the oropharynx;
• you can try to squeeze the child's chest - jerky. In this case, a stream of air escaping from the lungs, as a rule, pushes the foreign body out;
• if a fish bone is stuck in a child’s throat, you should seek help from an ENT doctor (otorhinolaryngologist), but it happens that it is not always possible to meet with a doctor quickly. If a mother sees a fish bone in a child's throat, she can try to get it with tweezers. If the mother is sure that the bone is small (preparing a fish dish for the baby, she removed all the large bones from the fish), she can resort to the tried and tested folk method - let the child swallow a small piece of unchewed bread crumb. Usually the crumb, passing through the pharynx, carries the bone with it.

Foreign objects in the baby's body

You can understand that a child has a foreign body in his ear if you notice that he is restlessly shaking his head, rubbing and tugging at his ear all the time, and crying.

Try to pull the top of the ear up and to the side, thereby straightening the ear canal. Then tilt the baby's head with that ear down and shake gently. At the same time, you can pour some warm water into the baby's ear. If you're lucky, the water will wash out the object that got into your ear.

The fact that the baby put a bead, pea or something similar in his nose, you can find out by some signs. First, the child may rub the side of the nose where the foreign object is stuck and try to put a finger in the nostril. Secondly, an object stuck in the nose can prevent free breathing from the "sick" side.

As a rule, constant mucous discharge comes from this nostril; if the object is rough, it can damage the nasal mucosa, and then blood will ooze from the nostril.

For a small child who cannot blow his nose on his own, you can try to make a few strong exhalations from mouth to mouth, while pressing a freely breathing nostril with your finger.

• If after several attempts to remove the object stuck in the nose fails, urgently take the child to the hospital.
• Often, various “specks” get into the eyes of children - grains of sand, small insects, cilia, etc.
• To remove a foreign body from the eye:

• lay the baby on its side with the sore eye up, open the eyelids with your fingers and rinse the eye with water from a pear or a syringe without a needle;
• you can try to very carefully pick up the mote with a flagellum from a damp cotton wool or a corner of a clean handkerchief;
• if there is nothing under the lower eyelid, and the eye continues to hurt, grab the eyelashes of the upper eyelid and pull it over the lower one. The mote, located under the upper eyelid, in this case, may move down, and you can try to remove it;
• if it is difficult to remove a foreign body or pain and pain in the eye do not go away, cover the eye with a cotton pad or just a piece of cotton wool, secure it with a bandage or an ordinary small handkerchief and take the baby to the hospital;
• Don't let your child rub their eyes!

In no case do not try to remove the foreign body yourself if it is on the iris or is embedded in the eyeball!

Treatment of foreign bodies

When a foreign body enters the throat, the pat on the back method is suitable for first aid for the smallest. At the same time, put the child on your knee. Slap between your shoulder blades.

Turn the baby over, lay it on a flat surface on its back and make a few quick and strong pressures on the chest. Press the root of the child's tongue with your hands and pull back the lower jaw, inspect the throat.

If you see an object, try to remove it.

Do not give toys with small removable or easily detachable parts to children under five years of age, and keep buttons, paper clips and other small items out of reach. If the child plays alone in the room and is quiet, then pay attention to his occupation and condition.

If, after the measures taken, breathing has not recovered, it is necessary to do artificial respiration. In children older than a year, you can press your hands on your stomach. To do this, lay the child on a horizontal surface.

Place the palm of one hand between the navel and ribs, put the palm of the other hand on top. Next, perform 7-9 quick presses on the stomach inward and upward. Examine the larynx again and try to remove the foreign body if you see one.

If these measures do not help, give mouth-to-mouth artificial respiration. Do not exhale the entire supply of air into the child, since his lung capacity is much smaller than that of an adult.

If the child is conscious, stand behind him, put your fist on his stomach so that the thumb is above the navel. Try not to hurt your chest. Place the other palm on top and make 7-9 pressures on the stomach inward and upward. During these urgent manipulations, try to call an ambulance.

Do not try to get an object stuck in the nose.

Treatment in this case is possible only in a hospital setting. It consists in removing a foreign body from the nose, after which all the above phenomena completely disappear.

Attempts to remove an object from the nose at home are best left. You can only push it into the trachea or larynx, which will cause rapid tissue swelling and suffocation.

Foreign bodies of the pharynx. Symptoms and treatment

A foreign body that has fallen into the throat is a common occurrence in otorhinolaryngology, and in many cases this situation is not only painful for the victim, but also life-threatening.

Foreign bodies extracted by ENT doctors are surprisingly diverse: organic and inorganic objects, namely food, toys, glass fragments, metal parts, living organisms, medical materials and many other, sometimes completely unexpected objects.

The age of patients also varies within the widest range: they can be children of the first months of life, and adult adequate people, and deep old people.

Sometimes the discomfort caused by a foreign body in the pharynx is quite tolerable: in such cases, the victims tend to make certain attempts to remove the object on their own or wait, say, until the morning before going to the doctor.

But sometimes, due to reflex spasm, blockage of the airways, perforation of the walls or injury to the mucous membranes, it is necessary to act very quickly and competently, since the count goes literally for seconds.

2. Reasons

The most typical situation when a foreign body enters the pharynx is eating. This is facilitated by any factors that distract attention from the actual food: talking, reading, watching TV, haste, severe intoxication, etc.

Situations are also very common when a small child tries to “taste” inedible objects - buttons, coins, toys or their parts, nuts in shell, etc.

Especially severe consequences are fraught with attempts to swallow objects with sharp edges or piercing protrusions.

However, despite the general literacy and, it would seem, parents' understanding of such a danger, such situations are repeated again and again: even in the most prosperous families, a child can find himself alone with needles, pins, hairpins, etc.

Quite typical are cases when a person repairs or makes something, while holding fasteners, parts, tools with teeth or lips: with a distracting irritant from the side, accidental slipping, urge to sneeze, momentary loss of coordination of movements, there is a high risk of accidental swallowing or inhalation . Often, under similar circumstances or during a night's sleep, ill-fitting removable dentures turn out to be a foreign body in the pharynx.

Less common is the ingestion of sufficiently large living organisms with consumed food or water; helminths from the intestine through the stomach and esophagus; “falling through” of foreign bodies from the nasopharynx (for example, when trying to remove it without consulting a doctor), as well as foreign bodies of iatrogenic origin - tampons, materials, devices or their accidental fragments left after medical procedures.

3.Symptoms and diagnosis

The most common symptoms are pain syndrome (often with irradiation to neighboring organs), a feeling of fullness, hypersalivation (intense salivation), urge to cough and/or vomit, difficulty or inability to swallow.

As shown above, clinical manifestations can be moderately expressed (for example, when a fish bone is swallowed and stuck, even if it is stuck into the mucous membrane with a sharp end or a notch), but in some cases the entrance to the larynx is completely blocked - accordingly, suffocation (asphyxia) occurs) , and, if the situation is not resolved in one way or another, the victim dies in the next few minutes.

Frequent complications include bleeding, swelling and infection caused by mechanical damage to the mucous membranes; in the absence of timely medical care, an acute purulent-inflammatory process can cause abscess formation, large-scale life-threatening phlegmon or sepsis.

Diagnosis of foreign bodies in the ENT organs is quite simple in some cases, in others it is complicated, and sometimes impossible in principle, no matter how paradoxical it may sound.

Thus, large foreign bodies at the level of the oropharynx are usually easily visualized and palpated. It is more difficult to detect small objects, especially if they are localized in folds, transparent or merge in color with the mucous membrane.

An x-ray may also be uninformative if the object is too permeable to x-rays or does not contrast with surrounding tissues.

In such cases, artificial enhancement of X-ray contrast, MRI, endoscopic methods are used.

Finally, it is impossible to detect an object in the pharynx that is not there: often the sensation of a foreign body is caused by a growing tumor, inflammation, vertebrological pathology or microtrauma from a sharp object - which really went into the pharynx, but from there, for example, immediately got into the esophagus and then naturally was excreted by intestinal peristalsis. Often, people with hypochondriacal neurosis, senestopathic hallucinatory-delusional disorders, or other psychopathological symptoms, which are not always quickly recognized as such, also complain about a foreign body in the pharynx; in this regard, the otorhinolaryngologist must pay attention to the nature, emotional accompaniment and wording of complaints (often pretentious, obscure or anatomically implausible), behavior and general psychological state of the patient.

4.Treatment

Removal of foreign bodies from the pharynx is a task, the solution of which depends on many factors (size, shape, localization, associated complications, risk of dangerous displacement, age of the victim, etc.).

In some cases, it is enough to perform the well-known Heimlich maneuver (a sharp push under the diaphragm, while the victim should be tilted forward), in others, saving life requires emergency cardiopulmonary resuscitation (it is recommended to study in detail and master the algorithm of emergency first aid, popularly described in many sources) .

At an outpatient or emergency appointment, if the situation allows, special otorhinolaryngological instruments (various tweezers, forceps, loop hooks, clamps, etc.) are widely and, as a rule, successfully used, however, in some cases, endoscopic or surgical intervention under general anesthesia.

After removal of the foreign body, a thorough antiseptic treatment is performed, analgesics and sedatives, rinses, and a sparing diet are prescribed as necessary until the injured mucous membranes are completely healed.

2.13. Restoration of airway patency (foreign bodies of the pharynx, larynx)

General concepts

Foreign bodies often get into the throat along with food (fish and meat bones, glass fragments, pieces of wire, pieces of meat, fat). Foreign bodies can also be objects accidentally caught in the mouth (pins, nails, buttons), dentures.

Less common are living foreign bodies (leeches, roundworms).

The ingress of foreign bodies into the pharynx is due to such predisposing moments as fast food, sudden laughter or coughing while eating, the absence of teeth or the presence of dentures, the habit of holding small objects in the mouth.

In the oropharynx, sharp and small foreign bodies usually get stuck, penetrating into the palatine tonsils, arches, and the root of the tongue. Large foreign bodies stop in the laryngopharynx (above the entrance to the esophagus). Much less often, foreign bodies enter the nasopharynx (with injuries of the nose and paranasal sinuses, vomiting).

Symptoms depend on the size of the foreign body, its shape, the place of introduction. The main symptoms: sore throat, aggravated by swallowing, sensation of a foreign object in the throat, difficulty in swallowing food, salivation.

Large foreign bodies stuck in the lower part of the pharynx disrupt speech, cause coughing and severe difficulty in breathing, asphyxia is possible. Hemoptysis can be a consequence of getting into the throat of a leech. At the site of the introduction of a foreign body into the pharyngeal wall, inflammation occurs, which increases pain.

With a long stay in the pharynx of a foreign body, complications are possible in the form of abscesses of the pharynx, phlegmon of the neck, sepsis, and bleeding. Often a foreign body that has already passed into the stomach injures the mucous membrane of the pharynx, which can cause symptoms of an imaginary foreign body.

The sensation of a foreign body may be associated with chronic inflammatory processes and tumors of the pharynx and excessive suspiciousness of the patient.

Diagnosis can be put on the basis of history, examination of the pharynx, palpation, radiography. Identification of large foreign bodies in the pharynx is not difficult. It is more difficult to detect small and transparent foreign bodies, as well as foreign bodies that have penetrated the pharyngeal wall.

Urgent care . Removal of a foreign body of the pharynx should be performed in the otorhinolaryngological office. As a rule, foreign bodies are removed on an outpatient basis. In case of asphyxia, one should try to remove the foreign body with a finger; in case of failure, a tracheostomy is necessary.

Foreign bodies of the larynx

Meat and fish bones, needles, pins, buttons, eggshells, dentures, coins, small parts of toys usually enter the larynx from the oral cavity, less often from the stomach when vomiting.

Foreign bodies such as parts of broken surgical instruments, tissue removed during surgery, and living foreign bodies (leeches, roundworms, bees, wasps) are much less common.

The mechanism of entry of a foreign body into the larynx is associated with an unexpected deep breath, during which an object in the oral cavity is drawn into the larynx by a stream of air.

• To aspiration of foreign bodies predispose:
• a bad habit of holding small objects in the mouth;
• conversation during a hurried meal;
• unexpected deep breath in case of fright, crying, falling;
• intoxication;
• Decreased reflexes of the mucous membrane of the pharynx and larynx in some diseases of the central nervous system.

No. 19. Foreign bodies of the pharynx

Purulent-inflammatory pathology of the neck.

Nonspecific inflammatory

Neck diseases are the most common

Are lymphadenitis and phlegmon (usually

Adenophlegmon), rarely furuncle, carbuncle

And erysipelas, which are often complicated

Meningitis and sepsis.

Purulent lymphadenitis

And phlegmon of the neck often develop in connection with

With the presence of foci of infection in carious

Teeth, with angina, pharyngitis, laryngitis,

Thyroiditis, inflammatory diseases

Salivary glands, facial skin and hairy

Parts of the head, children's inf. diseases, with

Wounds of the esophagus, pharynx, larynx.

Subcutaneous

Phlegmon, with a swarm of purulent

Inflammation is usually localized under

Subcutaneous muscle of the neck, manifested

Hyperemia, pain and swelling.

Phlegmon bed of the sternocleidomastoid

Muscles, often developed as a result of

Mastoiditis, clinically manifested

Pain in this area, soreness

Her on palpation.

Phlegmon suprasternal

Cellular space observed

With lymphadenitis and osteomyelitis of the handle

Sternum. She is characterized by swelling.

And the smoothness of the contours in the area

Jugular notch. terrible complication

Such phlegmon is spread

Purulent process behind the sternum, in the anterior

Mediastinum with the development of mediastinitis.

For submandibular phlegmon is characteristic

Sharp increase in pain when opening

mouth. With cellular phlegmon

spaces of the neurovascular bundle,

Developing sometimes with angina and

Mumps, possibly profuse bleeding

Due to erosion of large vessels.

When forming phlegmon ahead

Trachea purulent process can

Spread into the anterior mediastinum

And when it is localized behind the trachea - in

Posterior mediastinum followed by

The development of purulent mediastinitis.

The cause of deep phlegmon of the neck can

Be damage to the esophagus or trachea

foreign bodies.

If you suspect

Deep phlegmon of the neck are required

Plain radiography of the neck and chest

Cells, radiopaque study

Esophagus and fibroesophagoscopy. Chron.

Nonspecific (woody) phlegmon

The neck is caused by a weakly virulent microflora.

Such a phlegmon appears dense,

Woody infiltrate, expressed

Edema and cyanosis of the skin.

Anaerobic

Phlegmon of the supraclavicular tissue of the neck

Characterized by the presence of purulent

Foci, usually surrounded by unchanged

Fiber. Treatment

Inflammatory processes of the neck are usually

Start with conservative measures:

Prescribing antibiotics (semi-synthetic

Penicillins, aminoglycosides, cephalosporins)

Etc. While maintaining or increasing

Symptoms of intoxication, Progression

Inflammatory phenomena shown

Operational intervention.

foreign

bodies of the upper respiratory tract,

Particulars of the pharynx are common.

The reasons for their entry into the throat can

Be inattentive and hasty

When eating, talking or laughing

Meal time, coughing, sneezing while eating.

Children left unattended take

In the mouth and try to swallow various

Items. In the elderly, foreign

The bodies can be dentures.

Finally, in hot climates

Foreign bodies become falling

Together with the drunk leech liquid

Or other small insects.

foreign

The bodies can be of different nature and

Forms: fish and chicken bones, small

Metal objects, pieces of fruit,

Glass, etc.

Dependences on the shape and size are foreign

Bodies can get stuck in palatal tissue

Tonsils, lateral folds of the pharynx, lingual

Tonsil, valekula, pyriform sinus

Clinical

The picture is emerging

From the patient's complaints about the sensation of a lump in

Throat, the presence of pain in the throat, aggravated

When swallowing. For large foreign

Bodies stuck in the oropharynx

Airway obstruction possible

With subsequent asphyxia and lethal

Exodus.

Difficulties arise when there is a suspicion

The entry of a foreign body into the lower

Department of the pharynx, for example in the pear-shaped

A pocket in or near the pharynx's junction

Esophagus. One of the signs of a foreign

The body hidden in the piriform sinus,

It serves to retain saliva in it (salivary

Lake). In such cases, other than the usual

Laryngoscopy, direct

Methods using rigid esophagoscopes.

In some cases, a foreign body in the pharynx

May cause cellulitis or abscess

Lateral wall of the pharynx, as well as subcutaneous

Emphysema and mediastinitis, which requires

Appropriate surgical

interventions.

Diagnostics based

Based on the patient's complaints, anamnesis data and

Instrumental examination (mesopharyngoscopy,

epipharyngoscopy, indirect laryngoscopy).

To clarify the localization of a foreign

The body is a great help

radiographic examination,

Finger palpation of suspicious

Places Often subjective complaints

The patient is not caused by a foreign body,

A mucosal injury inflicted

Foreign body.

In such cases, it is necessary

Dynamic state control

The patient and a change in the pharyngoscope

Paintings for several days.

Treatment. Necessary

Removal of a foreign body in the pharynx

As a rule, after preliminary

Application anesthesia of the mucosa

Shells 10% solution of lidocaine.

foreign

The body can be captured by the guttural or

Nasopharyngeal forceps, sometimes tweezers.

If necessary, the wound surface

Lubricated with anesthetics, prescribed

Rinse with antiseptic solutions

Local anti-inflammatory therapy.

Foreign bodies of the esophagus

hit

Foreign bodies in the esophagus are mainly

Random character: along with bad

Chewed food, with careless,

Hasty food. Contribute to it

May be missing teeth and wearing dentures

Dentures, alcohol intoxication, harmful

Habits - holding nails with teeth,

Needles, coins, etc. Deliberately

Foreign bodies may be swallowed

Mentally ill people.

Character

Foreign objects may be the most

Diverse: small fish, birds

Bones, pieces of meat, coins, debris

Toys, dentures, etc.

foreign

Bodies get stuck in the esophagus in places

Physiological constrictions, most often in

Neck constriction. Powerful striated

Musculature determines in this department

Strong reflex contractions

Esophagus. 2nd place in frequency

Jamming of foreign bodies takes

The thoracic region and, finally, the third -

Cardiac.

Clinic at

Foreign bodies of the esophagus are determined

Their size, surface topography,

Level and location in relation to

To the esophagus.

The patient is worried about pain

Breast that gets worse when swallowing

Food, as well as the sensation of a foreign body.

In some cases, disruption

Characteristic forced position

Torso: head pushed forward,

Rotates along with the body

Face expression of fright. General state

The patient may not be disturbed.

Diagnostics. Survey

It is necessary to start with an inspection of the mountains

The hypopharynx. Sometimes a foreign body

May be in the palatine tonsils,

The root of the tongue, in the piriform sinus.

Indirect laryngoscopy can detect

An important sign of a foreign body or

Injuries in the first narrowing of the esophagus -

Accumulation of frothy saliva in the piriformis

Sinus on the affected side. Can

Observe edema and infiltration

arytenoid cartilage. When pressed

On the region of the larynx or trachea sometimes

Soreness is noted.

informative

X-ray examination of the esophagus

With contrast to reveal

Only foreign objects, but also constriction

Or a blockage in the esophagus.

In the presence of

Perforation of the esophagus caused by a foreign

body, x-rays can reveal

Accumulation of air in the esophagus

Cellulose in the form of a light spot between

spine and posterior wall of the lower

Department of the pharynx.

Leakage into the mediastinum

Contrast mass detected at

X-ray is also a sign

Perforations.

final

Conclusion about the presence of a foreign body

And its characterization is given by holding

Esophagoscopy using

Bronchoesophagoscopes Bryunings, Mezrin,

Friedel, flexible fiberscopes.

Treatment. Esophagoscopy

Is the main research method

Esophagus and removal of foreign bodies.

Complication. Spicy

An object wedged into the wall of the esophagus

Causes disruption of mucosal integrity

Shells and its infection. Emerging

Infiltration captures the muscle

The wall of the esophagus, and then, possibly,

Cellulose of the mediastinum.

Because the wall

The esophagus does not have a capsule outside or

Fascia, but surrounded only by fiber,

Foreign bodies can immediately cause

Through perforation with development

Mediastinitis.

If perforation occurs

In the upper parts of the esophagus, on the neck immediately

subcutaneous emphysema and

Crepitation of soft tissues.

Periesophagitis and mediastinitis, absence of

In the first hours of positive dynamics

Against the background of massive anti-inflammatory

Therapies are an indication for surgery

intervention and drainage

periesophageal fiber, which

Dependence on the level of damage to the esophagus

May be transcerebral and thoracic.

foreign

Bodies of the larynx, trachea and bronchi

foreign

The bodies of the larynx, trachea and bronchi meet

Often, but more often in children, which is associated

With underdeveloped defenses

Reflexes.

Foreign bodies can

Be any small items: bones

Fruits, grains, coins, small parts

toys, buttons, pins, etc. In adults

Foreign bodies enter the respiratory

Ways more often with alcohol intoxication.

Possible inhalation

Dentures, food pieces, vomit

Mass and others.

Foreign bodies of the pharynx

The ingress of foreign bodies into the pharynx is a frequent phenomenon. In terms of frequency, fish bones are in the first place as foreign bodies.

Most often, foreign bodies enter the pharynx with food during hasty eating and insufficient chewing, the absence of teeth, diseases of the masticatory apparatus and with reduced sensitivity of the oral mucosa. Intoxication, wearing removable dentures contribute to the ingress of foreign bodies into the throat.

Bad habits of keeping various objects in the mouth - pins, clerical braces, shoe studs, various hooks, fragments of matches, hay, etc. - cause them to be swallowed and sometimes get stuck in the throat. Often, foreign bodies of the pharynx are found in children with insufficient supervision of them.

In hot climates, foreign bodies can be leeches that enter the throat along with drinking water from reservoirs. In rare cases, roundworms also penetrate the pharynx.

Favorite places for the introduction of pointed fish bones, bristles, small sharp meat bones are the palatine tonsils, the posterior and anterior arches, the region of the root of the tongue and the pear-shaped fossae.

Pain, cough, choking in the throat, copious salivation are the most common complaints of patients with foreign bodies of the pharynx.

Foreign bodies that have penetrated into the pharynx or the presence of their unremoved remnants cause complications in the form of an inflammatory reaction up to the formation of phlegmon and abscesses.

However, patients may also complain of sore throat after the foreign body is removed due to abrasions or scratches caused by them. But there are patients who, having swallowed a foreign body, in the future do not notice its presence for a long time (several months and even years).

The diagnosis is established according to the anamnesis and pharyngoscopy. The presence of a foreign body in the oral part of the pharynx is established upon examination. To detect small thin fish bones and especially bristles from toothbrushes, special care and consistency in the examination of the pharynx is required.

When a foreign body is supposed to be in the tonsil, it is necessary to move the anterior arch with a spatula and, having somewhat dislocated the tonsil, examine its lacunae, where foreign bodies can hide. To detect foreign bodies in the lower pharynx, laryngoscopy and hypopharyngoscopy are necessary.

Metallic foreign bodies in the pharynx are relatively easy to recognize using X-rays.

Urgent care. Detected foreign bodies in the pharynx, in the pharynx are subject to removal. Extracting them (fish bones, oat grains, etc.) can be done with tweezers or a curved forceps with tightly adjoining branches. Foreign bodies are removed from the nasopharynx with forceps or Yurash forceps, for which you need to raise the soft palate.

Scratches and abrasions formed on the mucous membrane after a foreign body can simulate its presence for a long time and cause anxiety to patients. To extract foreign bodies from the pharynx, sometimes you have to resort to anesthesia.

Patients with foreign bodies of the pharynx with signs of shortness of breath should immediately be sent to a surgical or otolaryngological hospital.

Foreign body of the pharynx: features of the disease and symptoms

Foreign bodies in the pharynx of the esophagus are bodies that are alien to the human body.

Causes

Foreign bodies of the pharynx mainly enter the body with food (fish bones, cereal husks, pieces of wood, etc.), sometimes they can be pieces of dentures, as well as pins, hairpins or small nails (for garment workers , shoemakers).

With poor chewing and rapid swallowing, large pieces of food can get stuck in the upper region of the esophagus, close the inlet to the larynx and cause suffocation (asphyxia).

Laughter or talking while eating can also provoke this condition. In almost all cases, foreign bodies of an acute form get stuck in the throat, tonsils, at the root of the tongue, sometimes in other parts of the pharynx.

Symptoms

Foreign body in the throat symptoms:

• sensation of a foreign body in the throat;
• pain and difficulty in swallowing movements;
• violation of breathing and speech (if large foreign bodies enter the larynx);
• if the foreign body of the pharynx is not removed in a timely manner, an inflammatory process may develop, and in some cases a phlegmon may form.

Diagnosis

The diagnosis is established in the process of examining the pharynx, palpation (if small foreign objects have penetrated deeply), as well as during an x-ray examination to identify metal objects.

Very often, patients complain about a foreign object in the larynx, and the examination shows only an injury from an object that was swallowed.

It is abrasions and scratches that can provoke a sensation in the throat or esophagus of a foreign body for a long time.

Foreign bodies in the pharynx first aid

First aid for a foreign body in the pharynx is carried out by removal using forceps or cranked tweezers.

Foreign bodies of the pharynx, esophagus, larynx, trachea and bronchi

Among the cases of foreign bodies of the upper respiratory tract in the practice of an otorhinolaryngologist, fish bones are the most common. The peak of referrals for the removal of fish bones occurs in the summer months, when there is a lot of freshly caught river fish in the diet. Samara is no exception, as it stands on the Volga River.

Removal, pushing of fish bones is carried out at home with a crust of bread. Most often, small, thin bones get stuck - ribs.

The bone gets stuck in the upper respiratory and digestive tracts at the time of swallowing.

The most favorite places for bone fixation in the pharynx are the palatine tonsils, the lingual tonsil, the lateral ridges, the posterior palatine arches, and the pyriform sinuses. The palatine tonsils become a target for fish bones, as they actively accompany the food bolus at the time of swallowing. The lingual tonsil suffers for the same reasons.

The tissue of the palatine and lingual tonsils is represented by lymphadenoid tissue, which is very loose and easily strung on a thin fish bone. Concomitant pathology in the form of chronic tonsillitis with hypertrophy of the tonsils increases the risk of bone entering the tissue.

In the case when the bone is stuck in the upper parts of the pharynx and is in the line of sight, the removal of the fish bone in such a situation is not difficult. The situation with bone fixation in the lower parts of the pharynx requires the participation of a specialist. It is extremely difficult to remove such a bone without the help of an otorhinolaryngologist.

Complications of pharyngeal injury with fish bones are rare. Allocate such a form of angina as traumatic, with a long stay of the bone in the tissue of the tonsil, paratonsillitis may develop, which will end with a paratonsillar abscess.

Acute pharyngitis, lateropharyngeal abscess, mediastinitis, phlegmon of the pharynx, neck, sepsis, stenosis of the larynx as a complication is quite rare.

Removal of fish bones in Samara is performed by ENT doctors at Outpatient Center No. 1.

First aid.

Specialized help.

Prescribe anti-inflammatory therapy. If a foreign body in the pharynx is not found, and the pain syndrome is preserved, it is necessary to exclude a foreign body in the esophagus. For this purpose, fibrohypopharyngoscopy and esophagoscopy are performed.

Foreign bodies of the pharynx

Causes. Usually localized in the oropharynx and laryngopharynx, where they get with food, sometimes during manipulations in the mouth (pin, needle, toothpick).

The most common foreign body in the pharynx is a fish bone that pierces into the loose tissue of the palatine, lingual tonsils, into the vallecules of the root of the tongue. Less often, foreign bodies (coin, meat bone) are fixed in pear-shaped pockets.

Foreign bodies enter the nasopharynx from the nasal cavity (needle), from the lower parts of the pharynx during vomiting. It occurs more often in children and the elderly.

Symptoms. Sore throat when swallowing with irradiation to the ear (stabbing with fishbone), discomfort in the projection of a foreign body, sometimes hypersalivation, vomiting, difficulty swallowing.

Complications. Bleeding, acute pharyngitis, lateropharyngeal abscess, mediastinitis, phlegmon of the pharynx, neck, sepsis, stenosis of the larynx.

First aid. With pharyngoscopy, you should carefully examine the palatine tonsils, pushing the palatine arches, with indirect laryngoscopy - the root of the tongue, vallecules of the tongue, pear-shaped pockets. Finger examination is allowed.

The foreign body is removed with a forceps or tweezers under visual control, after which it is recommended to rinse the oropharynx with an antiseptic solution, adhere to a sparing diet. With a different localization of foreign bodies in the pharynx, the patient should be urgently hospitalized in the otorhinolaryngological department.

Specialized help.

Foreign bodies of the lingual tonsil, valleculae of the root of the tongue and pear-shaped pockets are removed with indirect laryngoscopy in adults and direct hypopharyngoscopy in children using a laryngeal forceps or forceps.

Prescribe anti-inflammatory therapy. If a foreign body in the pharynx is not found, and the pain syndrome is preserved, it is necessary to exclude a foreign body in the esophagus. For this purpose, fibrohypopharyngoscopy and esophagoscopy are performed.

Foreign bodies of the esophagus

Causes. Hasty eating, missing teeth, inadequate dentures, decreased pharyngeal reflex, alcohol intoxication, cicatricial narrowing of the esophagus. Foreign bodies usually get stuck in the area of ​​physiological narrowing, more often at the level of the first thoracic vertebra.

Symptoms. The onset of the disease is sudden, associated with food intake. Characterized by pain in the throat or behind the sternum with irradiation to the back, interscapular region, dysphagia, aphagia, salivation, general weakness, malaise, pain on palpation of the neck (left), aggravated by tapping on the spine, possibly forced head position.

When a foreign body is localized in the area of ​​the first physiological narrowing of the esophagus, the head is tilted forward, down, the patient keeps it motionless, turns the whole body. With the localization of a foreign body in the thoracic esophagus, the position of the patient is half-bent ("pose of a carrying person").

With indirect laryngoscopy, swelling, hyperemia of the mucous membrane in the region of the aryepiglottic folds, arytenoid cartilages, and accumulation of saliva in the pear-shaped pocket (usually the left one) are revealed. Possible urge to vomit, cough. A large foreign body can cause difficulty in breathing through the larynx.

Complications. Perforation of the esophagus, periesophagitis, mediastinitis, bleeding from the main vessels.

First aid.. Immediate evacuation to hospital. It is forbidden to try to push a foreign body by swallowing bread crusts, using bougie.

specialized assistance provided by otorhinolaryngologists together with endoscopists. To do this, an indirect laryngoscopy is performed, an x-ray examination of the cervical region in two projections (according to G.M. Zemtsov), which makes it possible to detect the shadow of a foreign body, indirect signs of a non-contrast foreign body of the esophagus or damage to its walls.

These symptoms are:

• straightening of the cervical spine due to tension of the scalene muscles;
• expansion of the prevertebral space;
• the presence of a symptom of an air “arrow” - an accumulation of air that has come out of the stomach, below the level of a foreign body, a pointed end of the “arrow”, indicating the location of the foreign body;
• striped enlightenment in the prevertebral space is a sign of air penetration into the retroesophageal tissue or the development of putrefactive inflammation with the formation of gas.

For diagnostic and therapeutic purposes, fibroesophagoscopy is also carried out. If it is impossible to remove the strangulated foreign body of the esophagus during esophagoscopy, esophagotomy is performed. Prescribe anti-inflammatory therapy.

Foreign bodies of the respiratory tract

Causes. Aspiration of liquid or obstruction by particles of food, soil with a sudden deep breath, falling, crying, fright, talking, laughing.

This is facilitated by distraction of the victim's attention while eating, the habit of keeping foreign objects in the mouth, a decrease in the laryngeal-pharyngeal reflex, wearing removable dentures, alcohol intoxication, lack of consciousness in case of traumatic brain injury, poisoning.

Foreign bodies of the bronchi are more common (88%), less common are the trachea (8.8%) and larynx (3.2%). The clinical picture depends on the nature, form and level of the foreign body in the airways.

Foreign bodies of the larynx

Symptoms.

First aid for foreign bodies in the ear, nose, eye, respiratory tract, etc.

There are two types of foreign bodies of the ear - living and non-living.

live- these are various insects (bugs, cockroaches, midges, flies, etc.), inanimate- small objects (buttons, beads, peas, seeds from berries, seeds, pieces of cotton wool, etc.) that fall into the external auditory canal.

Most often, foreign bodies, as a rule, do not cause any pain and their presence in the ear does not lead to any serious consequences. Therefore, first aid in such cases is not required.

It must be emphasized that any attempts by others or the victim himself to remove a foreign body can only contribute to further pushing these bodies deep into the ear canal.

The removal of such foreign bodies by a non-specialist is strictly prohibited, as this can lead to serious complications: perforation of the eardrum, infection of the middle ear, etc.

Living foreign bodies can cause unpleasant subjective sensations - a feeling of drilling, burning and pain.

First aid.

• When providing first aid, it is necessary to fill the ear canal with liquid oil, alcohol, or water and force the victim to lie down on the healthy side for several minutes. In this case, the insect dies, and subjective severe disorders immediately disappear.
• After the disappearance of discomfort in the ear, the patient must be put on the affected side. Often, a foreign body is removed from the ear along with the fluid.
• If the body (remains in the ear), then the patient should be taken to an otolaryngologist.

Foreign bodies of the nose.

They are more common in children who themselves push small objects into their noses (balls, beads, pieces of paper or cotton wool, berries, buttons, etc.).

First aid.

• As a first aid, you can advise the patient to blow his nose hard, while closing the second half of the nose.
• Removal of foreign bodies is performed only by a doctor. There is no particular urgency in removing foreign bodies, however, you should consult a doctor in the first days, since their prolonged stay in the nose leads to the development of inflammation, swelling, and sometimes ulceration and bleeding.

Foreign bodies of the eye.

Small, non-sharp objects (motes, midges, grains of sand, etc.), lingering on the conjunctiva (mucosa), cause an acute burning sensation in the eye, aggravated by blinking, and lacrimation. If the foreign body is not removed, conjunctival edema, redness occur, and eye function (vision) is impaired. The foreign body is usually located under the upper or lower eyelid.

First aid.

• The sooner the foreign body is removed, the sooner all the phenomena caused by it will pass. You can not rub your eyes, as this irritates the conjunctiva even more.
• It is necessary to examine the eye and remove the mote. First, the conjunctiva of the lower eyelid is examined: the patient is asked to look up, the assisting person pulls the lower eyelid down, then the entire lower part of the conjunctiva becomes clearly visible.
• The foreign body is removed with a dense swab, dry or moistened with a solution of boric acid.
• Removal of a foreign body from under the upper eyelid is somewhat more difficult - it is necessary to turn the eyelid outward with the conjunctiva. For this, the patient is asked to look down, assisting, grabbing the upper eyelid with two fingers of the right hand, pulls it forward and down, then with the index finger of the left hand, superimposed over the upper eyelid, twists it upwards.
• After removal of the foreign body, the patient is asked to look up, and the everted eyelid returns on its own to its normal starting position. Any round stick, pencil, etc. contributes to eversion of the eyelid.
• In order to prevent infection, after removal of a foreign body, 2-3 drops of a 30% solution of sulfacyl sodium (albucid sodium) are instilled into the eye. It is strictly forbidden to remove foreign bodies that have penetrated the cornea. This can only be done in a medical institution.
• With foreign bodies that have penetrated, as well as with injuries penetrating the cavity of the eyeball, as a first aid, 2-3 drops of a 30% solution of sulfacyl sodium can be instilled into the eye and a sterile gauze bandage applied to the eye. Such patients should be immediately taken to the hospital.

Foreign bodies of the respiratory tract.

Unforeseen situations happen during dental treatment. One of them includes a part of the endodontic device, which remained in the cavity as a result of root canal treatment. In such a situation, it will be necessary to remove the foreign body from the canal of the tooth. How is the procedure carried out, how can the patient find out about the presence of a foreign object?

Causes of ingress of foreign particles

A foreign object is in the canal of the tooth in the process of complex treatment, and part of it remains in the cavity in the following situations:

1. If the channels are winding and narrow. The tool does not cope with the tension and breaks.
2. In the process of cleaning from blood vessels and dead nerve.
3. When work was carried out with hand tools, where there is a risk of breakage of parts due to a defect or thinning of the metal.

Canal treatment does not always lead to breakage of instruments, but such a possibility is not excluded in therapeutic dentistry.

Signs of the presence of a foreign instrument in the cavity

Immediately after a foreign body enters the canal, the patient does not feel any symptoms. But over time, corrosion of the metal occurs, and inflammation begins. Irritation of the cavity leads to the destruction of the root, and the preservation of the tooth becomes an almost insoluble problem.

What symptoms should alert the patient?

• Pain while eating. Such a sign means that a periodontal abscess has begun inside - pus presses on the tissues of the teeth.
• Tissue edema is noted.
• A fistula is formed, and through it the pus goes into the oral cavity. In such a situation, the pain subsides, but this does not mean an improvement.

On examination, the doctor clarifies the nature of the pain, but the main method of research and detection of a foreign body is an x-ray.

Tool particles are foreign objects that must be removed. This is necessary to prevent the occurrence of corrosion, which provokes root cracks and leads to tooth loss. But this is far from the only unpleasant consequence.

The fragment present in the root does not allow the canal to be completely sealed. The main problem lies in the inflammatory process, which invariably occurs in such a situation. If an inflamed pulp remains under a piece of a foreign body, rotting begins. This phenomenon requires an urgent solution to the problem.

How is a foreign body removed from a tooth canal?

Prior to removal, the doctor needs to create good access to the foreign object. Then the part of the instrument remaining in the cavity loosens and moves away from the dentin. At this stage, an ultrasonic device is used. Then, with a special device, the dentist takes the tip of the object and pulls it out. An open wound is being treated.

Extraction options depending on the foreign body

Tactics for solving the problem depend on the type of object left in the cavity.

1. Fragments of pins are removed easily. To do this, the cavity is freed from the old filling by ultrasound, then the foreign body is loosened with a large amplitude for several minutes. This is done using ultrasound under the influence of chilled water to prevent hypothermia. When the doctor is convinced of good mobility, he removes the body with a special device.
2. Parts of endodontic instruments are more difficult to remove. The fragments are too small, so you will need to use a microscope. Such work is rightly called jewelry and only a professional can do it. To access the fragment, the canal is prepared, but small, so as not to damage the root. With high-frequency ultrasound at low or medium amplitude, a part of the instrument remaining in the cavity is cleaned and loosened. Extraction is carried out similarly to the first method.

Service cost

The price for the extraction of foreign bodies is set in each individual case individually. Estimated rates:

• Extraction - from 9000 rubles.
• Unsealing the canal - from 1,800 rubles.

What to do after the procedure?

Any endodontic treatment requires avoiding hot food for two hours after the procedure. During this period, anesthesia is still working, so there is a risk of biting your lip, tongue or cheek. It happens that a temporary filling falls out after the initial appointment. In such a situation, the patient should immediately consult a doctor so as not to infect the open wound. After filling, the doctor will prescribe a control x-ray.

Possible Complications

Extraction of a foreign object in itself does not carry complications. But there is a risk of damage to the root wall, poor-quality filling or a large amount of filling material introduced that protrudes beyond the tooth. Such complications have characteristic signs: pain and swelling around the affected area. You will need to go back to the dentist.

Only an experienced and qualified doctor can remove a foreign body from the canal using specialized tools and equipment. This is a complex procedure, which is important to do efficiently and competently. And good anesthesia will make it painless for the patient.