We present a case of a foreign body which migrated to the maxillary ostia by mucociliary action from its initial location on the floor of the maxillary sinus where it was traumatically introduced. This report illustrates that a powerful mechanism of mucociliary action can cause relatively heavy objects within the maxillary sinus to migrate naturally to the sinus ostia against gravitational force.
This report describes a migratory fish bone which was not found during 1st surgery causing perforation to the superior part of the arch of aorta. The patient presented with feeling of something stucked in her throat after eating fish subsequently followed by progressive excruciating pain in the neck. During 2nd surgery the fish bone was found to have migrated from the superior aspect of the arch of aorta to the anterolateral aspect of the arch of aorta after piercing the aortic lumen. We report a case of migratory fish bone which was not found during 1st surgery. The clinical examination of the throat revealed no foreign body. The CT scan of the neck and upper thorax demonstrated a 1cm linear foreign body part of which had perforated into the superior part of the arch of aorta with mediastinal hematoma. The most likely cause was a fish bone. The patient's condition slowly deteriorated, median sternotomy and exploration of mediastinum then followed. Unfortunately no fish bone was found and only mediastinal hematoma was discovered. After the first operation the patient condition did not improve and repeat CT scan of the neck and upper thorax was done 3 days later. A similar foreign body has now moved from the superior aspect of the arch of aorta to the anterolateral aspect of arch of aorta. Exploration was done again and this time the fish bone was found.
Migration of a foreign body from the hypopharynx to the subcutaneous tissue of the neck is a rare event. We report a case of a 48-year-old male who accidentally swallowed a fish bone which was not identified intraoperatively. The patient then presented with migration of the bone to the soft tissue of the neck. We conclude that careful assessment of the patient with a foreign body in the throat is crucial to avoid fatal complications.