Vol.100 No.11 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 100 No. 11 November 2007
A Infant Case of a Chopstick as a Foreign
Body in the Parapharyngeal Space
Toshiro Kawano, Junichi Ishitoya and Ryo Endou
(Yokohama University Medical Center)
Mamoru Tsukuda
(Yokohama City University Graduate School of Medicine)
We sometimes experience infant cases leading to unexpected deaths due to foreign bodies. It is often difficult to identify the cause or foreign body invasion by asking questions directly to a child. We experienced an infant case of a chopstick passing through the soft palate, reaching the parapharyngeal space near the inner carotid artery circumference. At the first medical examination, we could not detect the tip of the chopstick, in the pharynx. Using 3-directional-CT images, we could locate the tip of the chopstick in the parapharyngeal space near the inner carotid artery circumference. Under general anesthesia, we could remove the tip of the chopstick from the parapharyngeal space near the inner carotid artery with an endoscope trans-orally.
It is important to investigate positional conditions between a foreign body and the vessels in the parapharyngeal space. Images such as enhancing 3-directional-CT before the operation is useful.
Furthermore, we have to be careful of the late neurosis by pencil-injury in the region and pay close attention to respiratory tract management.
Key words : chopstick, foreign body, parapharyngeal space, pencil-injury