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Case Reports
. 2022 Jul 27:9:949964.
doi: 10.3389/fsurg.2022.949964. eCollection 2022.

Case report: Image guidance retrieval of a foreign body in retropharyngeal space

Xingmei Wu  1 , Yongquan Wang  1 , Wei Sun  1 , Xiaolin Zhu  1
Affiliations
Case Reports

Case report: Image guidance retrieval of a foreign body in retropharyngeal space

Xingmei Wu et al. Front Surg. .

Abstract

Background: Ingested foreign bodies fully embedded in retropharyngeal space present a unique challenge, as they can be difficult to locate and visualize via classic transoral laryngoscopy or the transcervical approach.

Methods: We retrieved a complete extraluminal chicken bone located in the patient's retropharyngeal space at the level of the C4-C5 spine through a well-designed transcervical approach with a combination of image-guided neck navigation.

Conclusion: A combined use of image-guided neck navigation and a dedicated transcervical approach for location of a foreign body in the retropharyngeal space is practical and available for clinical application.

Keywords: case report; foreign body; head and neck; image guidance navigation; retropharyngeal space.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
(A, B) Axial and sagittal CT images of patient on initial presentation; (C) laryngoscopy view of the posterior wall of the pharyngeal cavity before incision during the first surgery; (D) laryngoscopy view after incision of the pharyngeal mucosa during the first surgery. CT = computed tomography.
Figure 2
Figure 2
(A, B) Sagittal CT image and three-dimensional construction image of the patient after direct laryngoscopy ((A): the red arrow points to the foreign body); (C) representative images of intraoperative navigation registration: head and face contour scanning, combined with a facial marker, was used for registration, with an average registration accuracy not greater than 1.0 mm. After the model registration is completed, the patient's body position is further adjusted according to the positioning of the superior thyroid notch and the manubrium sterni (green) in the navigation model, so that the neck position from the navigation model matches the actual position of the patient’s neck.
Figure 3
Figure 3
Representative images of transcervical surgery with the combined use of both endoscope and image guidance navigation. (A) Exposure of the thyroid cartilage, thyrohyoid membrane, superior horn of the thyroid cartilage, and superior laryngeal nerves; (B) incision of a thyrohyoid membrane involved making an opening to the pharyngeal cavity; (C) successful location and retrieval of a foreign body from retropharyngeal space; (D) intraoperative positioning of the foreign body using image guidance navigation; (E) image of the foreign body.
See this image and copyright information in PMC

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