Hostname: page-component-586b7cd67f-r5fsc Total loading time: 0 Render date: 2024-11-22T20:00:06.141Z Has data issue: false hasContentIssue false

Lateral soft tissue neck X-rays: are they useful in management of upper aero-digestive tract foreign bodies?

Published online by Cambridge University Press:  15 August 2007

A Karnwal*
Affiliation:
Department of Head and Neck SurgeryDudley Group of Hospitals NHS Trust, UK
E C Ho
Affiliation:
Department of Head and Neck SurgeryDudley Group of Hospitals NHS Trust, UK
A Hall
Affiliation:
Department of Radiology, Dudley Group of Hospitals NHS Trust, UK
N Molony
Affiliation:
Department of Head and Neck SurgeryDudley Group of Hospitals NHS Trust, UK
*
Address for correspondence: Dr Abhishek Karnwal, 95 Kennet House, Bushey Fields Road, Dudley DY1 2LU, UK. Fax: 0044 1384 244169 E-mail: [email protected]

Abstract

Objectives:

To assess the value of lateral soft tissue neck X-rays in patients presenting with upper aero-digestive tract foreign bodies.

Design:

Retrospective study.

Inclusion criteria:

(1) Patients referred to the ENT team, via either the accident and emergency department or their general practitioner; (2) a history of a non-aspirated, upper airway, aero-digestive tract foreign body; and (3) a lateral soft tissue neck X-ray taken on admission.

Results:

A total of 62 patients met the inclusion criteria. Twenty-four patients (38.7 per cent) had positive findings on lateral soft tissue neck X-ray. ‘Soft’ signs, such as widened pre-vertebral shadow and loss of lordosis, were seen in all 24 patients, and foreign bodies were visualised in six patients. Overall, lateral soft tissue neck X-rays were helpful in the management of 32 patients (51.6 per cent). Rather worryingly, doctors in the accident and emergency and ENT departments missed 79.2 and 66.6 per cent of the positive findings, respectively.

Conclusions:

A lateral soft tissue neck X-ray is a helpful tool in the management of patients presenting with upper aero-digestive tract foreign bodies. Junior doctors need better radiology training.

Type
Main Article
Copyright
Copyright © JLO (1984) Limited 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Presented at the Midlands Institute of Otology meeting, 5 January 2007, Stoke on Trent, UK.

References

1Walner, DL, Ouanounou, S, Donnelly, LF, Cotton, RT. Utility of radiographs in the evaluation of paediatric upper airway obstruction. Ann Otol Rhinol Laryngol 1999;108:378–83Google ScholarPubMed
2Fleisher, GR, Ludwig, S. Textbook of Paediatric Emergency Medicine. Baltimore: Williams & Wilkins, 2005Google Scholar
3Silva, AB, Muntz, HR, Clary, R. Utility of conventional radiography in the diagnosis and management of paediatric airway foreign bodies. Ann Otol Rhinol Laryngol 1998;107:834–8CrossRefGoogle ScholarPubMed
4Esclamado, RM, Richardson, MA. Laryngotracheal foreign bodies in children. A comparison with bronchial foreign bodies. Am J Dis Child 1987;141:259–62CrossRefGoogle ScholarPubMed
5Halvorson, DJ, Merritt, RM, Mann, C, Porubsky, ES. Management of subglottic foreign bodies. Ann Otol Rhinol Laryngol 1996;105:541–4CrossRefGoogle ScholarPubMed