The Accuracy of Digital Radiography for Diagnosis of Fishbone Foreign Bodies in the Throat

Abstract Introduction Some patients with a fishbone as a foreign body of difficult diagnosis may require further investigations. Generally, radiography is used as the first choice for finding the fishbone. Objective The objective of this study is to determine the accuracy of digital radiography for diagnosis of fishbone foreign body in the throat Methods This descriptive experimental study design has three phases. In the first phase, we assessed subject contrast and visibility of fishbone on a homogeneous background; as for the second phase, we evaluated the embedded fishbone in the fresh cadaver's throat. In the last phase, we studied the accuracy of radiography in diagnosing the fishbone foreign body at any site of the cadaver's throat. Results The subject contrast of 15 fishbones ranged from 0.94 to 0.99. All types of fishbone were obvious in the first phase, whereas, in the second phase, visibility of fishbone was varied. The subject contrast and diameter of fishbone did not show statistically significant correlation with visibility (p = 0.09 and p = 0.24, respectively). In the third phase, embedded fishbone in the base of tongue was detected with the highest accuracy (sensitivity of 1.00 (95%CI: 0.44-1.00) and specificity of 0.92 (95%CI: 0.65-0.99)); whereas, the tonsil was of difficult interpretation with poorest diagnostic value (sensitivity of 0.00 (95%CI: 0.00-0.56) and specificity of 1.00 (95%CI: 0.76-1.00)). Conclusion The digital radiography provides the highest accuracy and benefit to the diagnosis of a fishbone foreign body at the base of the tongue; whereas, the tonsil was of difficult interpretation.

Bacteriology of granulation tissue in laryngotracheal stenosis patients.

BACKGROUND: The formation of granulation tissue is an important factor promoting recurrence after surgical treatment of laryngotracheal stenosis. Bacterial infection was claimed to be the cause. OBJECTIVE: The present study aimed to identify the bacteriology of granulation tissue in laryngotracheal stenosis patients. MATERIAL AND METHOD: Data was collected prospectively. Granulation tissue found in the site of laryngotracheal stenosis was removed and sent to the microbiologic study to identify the organisms. RESULTS: Twenty-four specimens from 17 patients were included in the present study. Coagulase-positive Staphylococcus (45.8%) was the most common gram-positive organism and Pseudomonas aeruginosa as well as Enterobacter species (16.7%) were the most common gram-negative bacteria. Ciprofloxacin may be the oral antibiotic that should be recommended. CONCLUSION: Coagulase-positive Staphylococcus, Pseudomonas aeruginosa as well as Enterobacter species were the common organisms identified from the granulation tissue in recurrent laryngotracheal stenosis. Oral antibiotics, such as ciprofloxacin, may have benefit in reducing the formation of this granulation tissue.

Dysphagia after total laryngectomy resulting from hypocalcemia: case report.

Although hypocalcemia is a common postoperative complication of patients who have undergone a total laryngectomy with total thyroidectomy for treatment of laryngeal cancer or cancer of adjacent organs and hypocalcemia can produce the symptom of dysphagia, there has never been a report that hypocalcemia is the cause of dysphagia in these patients. The authors reported two cases who had hypocalcemia after total laryngectomy with total thyroidectomy and presented with sudden and severe dysphagia. However, the symptom of dysphagia was dramatically improved after calcium replacement therapy.