A Rare Case Report: Oropharyngeal Foreign Body in an Alzheimer Patient

Ayşegül Şule Altindal
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Abstract

challenging otolaryngology emergencies. Foreign body aspiration is usually a serious condition that is most common among the pediatric age group, and rare in adults.1,2 The etiology of foreign body aspiration is often peanuts, which may be radiopaque on X-ray.3 Fish bone is the most common foreign body (FB) encountered in the pharynx.4-7 Most Pharyngeal foreign bodies (PFBs) are removed in the outpatient department. Only a few patient may have lack of cooperation and need extracting FBs in the hospital under general anesthesia. In clinical practice, many PFBs in patients are dislodged spontaneously before presentation. However, many reports have been associated with complications of PFBs, such as infections of the pharyngeal wall, retropharyngeal abscess, migration of FB, and even death.8-11 The majority of patients present with acute symptoms, like cough, dyspnea and hemoptysis, while others present with chronic symptoms.2-12 Most patients have an underlying disease, such as mental retardation, abnormal swallowing reflex, or neurological problems.13 In some adult patients, especially when Alzheimer disease is present, aspiration may be tolerated for a long time. Diagnosis must be established by means of symptoms, radiography, oropharyngeal examination and nasopharyngoscopy. Treatment is removal of the foreign body from the airway tract.2 Oropharyngeal wet wipes are very rare causes of pharyngeal foreign bodies around the world. Turkiye Klinikleri J Case Rep 2018;26(4):205-8
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阿尔茨海默病患者口咽异物一例报告
挑战耳鼻喉科急症。异物吸入通常是一种严重的疾病,在儿科年龄组中最常见,在成人中很少见。1,2异物吸入的病因常为花生,在x线上可能不透光鱼骨是咽部最常见的异物。4-7大多数咽异物(PFBs)是在门诊清除的。只有少数患者可能缺乏配合,需要在全麻情况下在医院取出FBs。在临床实践中,许多患者的PFBs在发病前自发移位。然而,许多报道与PFBs的并发症有关,如咽壁感染、咽后脓肿、FB迁移,甚至死亡。8-11大多数患者表现为急性症状,如咳嗽、呼吸困难和咯血,而其他患者表现为慢性症状。大多数患者有潜在疾病,如智力迟钝、吞咽反射异常或神经系统问题在一些成年患者中,特别是当存在阿尔茨海默病时,可能长期耐受误吸。诊断必须通过症状、x线摄影、口咽检查和鼻咽镜来确定。治疗方法是将异物从气道中清除口咽湿巾在世界范围内是引起咽异物的非常罕见的原因。中华医学杂志,2018;26(4):205-8
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