Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2022 Mar;60(1):59-62.
doi: 10.4274/tao.2021.2021-6-5. Epub 2022 May 12.

Challenging Removal of Embedded Fishbone in Tongue: Multimodal Technique, Surgical Approach and Consideration of Migration

Fathiyah Idris  1 , Foong Seong Kin  1 , Faizah Binti Mohd Zaki  2 , Marina Mat Baki  1
Affiliations
Case Reports

Challenging Removal of Embedded Fishbone in Tongue: Multimodal Technique, Surgical Approach and Consideration of Migration

Fathiyah Idris et al. Turk Arch Otorhinolaryngol. 2022 Mar.

Abstract

Fishbone ingestion is a common occurrence and patients present with various symptoms, posing challenges to the attending physicians. Here, we present two unique cases of patients with an unexpected rapidly migrating fishbone in the tongue. The first patient was operated transorally because of a foreign body embedded in the genioglossus muscle. In the second patient, CT scan located a fishbone embedded in the left hyoglossus muscle; however, the fishbone had to be relocated intraoperatively using bedside ultrasound guidance and was eventually found embedded within the mylohyoid muscle. The fishbone was successfully removed via transcervical approach following a failed transoral approach.

Keywords: Foreign bodies; case report; computed tomography; floor of mouth; foreign-body migration; surgery; tongue.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: No conflict of interest was declared by the authors.

Figures

Figure 1
Figure 1
Sagittal computed tomography scan of the neck showing the anterior (small arrow) and posterior ends (large arrow) of the fishbone embedded in the genioglossus muscle
Figure 2
Figure 2
An incision at the midline of the floor of the mouth slightly extended onto the ventral surface of the tongue. The tongue was sutured with silk and retracted superiorly
Figure 3
Figure 3
Sagittal computed tomography scan of the neck (first CT scan) showing a fishbone embedded in the tongue (white arrow) CT: Computed tomography
Figure 4
Figure 4
(a) Axial and (b) coronal computed tomography scan of the neck (second CT scan) showing a dense tubular structure in the left hyoglossus muscle (white arrow) CT: Computed tomography
Figure 5
Figure 5
Linear echogenic foreign body (yellow arrow) in the left submandibular space, approximately 1.4 cm anterior to the submandibular gland (labeled as SMG) and embedded in the left mylohyoid muscle
Figure 6
Figure 6
Linear fishbone embedded in the left mylohyoid bone (white arrow) was successfully removed
See this image and copyright information in PMC

References

    1. Johari HH, Khaw BL, Yusof Z, Mohamad I. Migrating fish bone piercing the common carotid artery, thyroid gland and causing deep neck abscess. World J Clin Cases. 2016;4:375–9. - PMC - PubMed
    1. Jamal S, Irfan M, Nazim N. Spontaneous extrusion of migrated fishbone in the neck after 48 hours of ingestion. Bangladesh J Med Sci. 2011;10:129–32.
    1. Luo CM, Lee YC. Diagnostic accuracy of lateral neck radiography for esophageal foreign bodies in adults. AJR Am J Roentgenol. 2020;215:465–71. - PubMed
    1. Lue AJ, Fang WD, Manolidis S. Use of plain radiography and computed tomography to identify fish bone foreign bodies. Otolaryngol Head Neck Surg. 2000;123:435–8. - PubMed
    1. Aras MH, Miloglu O, Barutcugil C, Kantarci M, Ozcan E, Harorli A. Comparison of the sensitivity for detecting foreign bodies among conventional plain radiography, computed tomography and ultrasonography. Dentomaxillofac Radiol. 2010;39:72–8. - PMC - PubMed

Publication types

LinkOut - more resources