Accuracy of Lateral Neck Radiography in Diagnosis of Foreign Body Ingestion
Chanticha Chotigavanich MD1, Ranista Tongdee MD2, Petcharat Aeimpongpaiboon MD1, Cheerasook Chongkolwatana MD1
Affiliation : 1 Department of Otorhinolaryngology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand 2 Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Objective : To determine the accuracy of plain lateral neck radiograph in diagnosis of foreign body [FB] in oropharynx, hypopharynx,
and cervical esophagus.
Materials and Methods : A prospective study was done on 57 patients presented with suspicion of FB ingestion. Plain lateral neck
radiography was done in all patients. The patients received complete ENT examination of oral cavity and pharynx and FB was
removed under local anesthesia if the FB was found. If the FB could not be found in oral cavity or pharynx and the patients still had
symptoms suspicious of FB impaction or FB in esophagus or presence of radiographic (cid:976)inding of FB, direct laryngoscopy and/or rigid
esophagoscopy under general anesthesia would be done to determine the presence of FB in hypopharynx or cervical esophagus.
Results : FB was found in 47 out of 57 patients, 23/47 (48.9%) at oropharynx, 9/47 (19.1%) at hypopharynx, and 15/47 (31.9%)
at cervical esophagus. Overall sensitivity and speci(cid:976)icity of plain lateral neck radiography to diagnose FB at oropharynx and
hypopharynx or cervical esophagus was 44.68% and 90%, respectively. However, the accuracy of plain lateral neck radiograph in
diagnosis of FB in hypopharynx and cervical esophagus (combined sensitivity 58% and speci(cid:976)icity 100%) were satisfactory and
higher than oropharynx (sensitivity 30% and speci(cid:976)icity 90%). The 23 oropharyngeal FB could be found by oral and pharyngeal
examination with 21 being removed at the clinics under local anesthesia.
Conclusion : Lateral neck radiography has higher detection rate for ingested FB that lodged in the hypopharynx or esophagus than
in the oropharynx. It should be done after negative oral and pharyngeal examination, which most of the oropharyngeal FB could be
found and removed. Appropriate direct laryngoscopy and/or rigid esophagoscopy should be considered according to the clinical
symptoms and results of plain lateral neck radiography.
Keywords : Lateral neck radiograph, Foreign Body, Sensitivity, Speci(cid:976)icity
