Dataset Information

Characteristics of fish-bone foreign bodies in the upper aero-digestive tract: The importance of identifying the species of fish.

ABSTRACT:

Background

Fish bones are common foreign bodies in the upper aero-digestive tract, but their clinical features in relation to fish species have not been confirmed. We aimed to clarify the clinical characteristics of fish-bone foreign bodies and their location and removal methods depending on the fish species.

Study design

Retrospective, observational, monocentric study.

Methods

From October 2015 to May 2020, 368 patients visited the Department of Otolaryngology-Head and Neck Surgery at Tohoku University Hospital complaining of dysphagia, sore throat, or pharyngeal discomfort after eating fish. We analyzed the patients' sex and age distribution, foreign-body location, type of the fish, and the techniques used for removing the foreign body.

Results

Fish bones were confirmed in the upper aero-digestive tract in 270 cases (73.4%), of which 236 (87.4%) involved fish-bone foreign bodies in the mesopharynx. The most frequently involved site was the palatine tonsil (n = 170). Eel was the most frequently observed fish species (n = 39), followed by mackerel (n = 33), salmon (n = 33), horse mackerel (n = 30), and flounder (n = 30). Among the 240 cases in which the bones did not spontaneously dislocate, 109 (45.4%) were treated by endoscopic removal (103 cases) or surgery (6 cases). In pediatric cases (<12 years old), almost all fish bones were found in the mesopharynx (138/139, 99.3%), and 31 cases (22.3%) required endoscopic removal. Flounder fish bones were often lodged in the hypopharynx and esophagus (9/30, 30%), hindering spontaneous dislocation and frequently necessitating endoscopic or surgical removal (19/29, 65.5%).

Conclusion

The characteristics of fish-bone foreign bodies differed depending on the fish species. Flounder bones were often stuck in the hypopharynx and esophagus and were likely to require more invasive removal methods. Confirming the species of the fish could facilitate appropriate diagnosis and treatment of fish-bone foreign bodies.

SUBMITTER: Shishido T

PROVIDER: S-EPMC8370622 | biostudies-literature |

REPOSITORIES: biostudies-literature

ACCESS DATA

Similar Datasets

Project description:Background:Cancer burden in sub-Saharan Africa is on the rise with one-third of cancers estimated to be caused by infectious agents. Head and neck squamous cell cancer (HNSCC) is the sixth most common malignancy in sub-Saharan Africa and includes tumors in the Upper Aero-digestive Tract (UADT). The established risk factors are tobacco and alcohol exposure with a recent recognition of the role of Human Papilloma Virus (HPV). The HPV related HNC is seen predominantly in the oropharynx, presents at a younger age and has a better prognosis. With a rapidly increasing incidence of these cancers in the developed world, it was important to study HPV in HNC in Uganda. The HPV can be detected using P16 immunohistochemistry as a surrogate marker thus making it suitable for screening. The study aimed at establishing the presence of HPV and the commonly affected sites in UADT squamous cell carcinoma (SCC) at Uganda Cancer Institute (UCI) using P16 immunohistochemistry. Methodology:This was a cross sectional study in which 59 patients with histologically proven SCC from the oral cavity, oropharynx, larynx and hypopharynx were recruited. These patients' demographics and clinical data were collected. Tissue sections from retrieved histology samples were stained by Haematoxylin and Eosin to reconfirm SCC. Subsequently, P16 expression was determined using P16 immunohistochemistry. Results:Seventy-one patients were enrolled and 59 patients with confirmed SCC of the sites of interest were analyzed. The majority (79.7%) of the participants were male and over 50?years. 59.3% were tobacco smokers, 66.1% used alcohol, 52.2% used both. Only 27.1% used none of the substances. Only 27.1% of the participants were HIV positive. Most of the tumors were in the larynx (37.3%) and 64.4% were overall TNM stage 4. The overall prevalence of HPV in UADT SCC at UCI was 20.3, 95%CI 10.9-32.8. The oropharynx had the highest prevalence (30.8%). Conclusion:The prevalence of HPV in UADT SCC at UCI is significant at 20.3%. The most affected site, is the oropharynx. Vigilant HPV screening of these sites with confirmation where possible is recommended.

Project description:The salivary microbiota is constantly swallowed and delivered to the digestive tract. These bacteria may be associated with gastrointestinal diseases. This case-control study examined the salivary microbiota in patients with digestive tract cancer (DTC) and evaluated their differential distribution based on the cancer sites. We collected saliva samples from 59 patients with cancer in any part of the digestive tract (tongue/pharynx, esophagus, stomach, and large intestine) and from 118 age- and sex-matched control subjects. There was no significant difference in periodontal status between DTC patients and control subjects (P = 0.72). We examined the bacterial diversity and composition in saliva by 16S ribosomal RNA gene sequencing. Salivary bacterial diversity in DTC patients was significantly higher than that in control subjects [number of operational taxonomic units (OTUs), P = 0.02; Shannon index, P < 0.01; Chao1, P = 0.04]. Eleven differentially abundant OTUs in DTC patients were identified using the linear discriminant analysis effect size (LEfSe) method. Based on the cancer sites, the diversity of salivary bacteria was especially higher in tongue/pharyngeal or esophageal cancer patients than in control subjects. Among the 11 differentially abundant OTUs in DTC patients, an OTU corresponding to Porphyromonas gingivalis was more abundant in the saliva of all groups of DTC patients compared to that in control subjects, and an OTU corresponding to Corynebacterium species was more abundant in all groups other than gastric cancer patients (P < 0.01). In addition, the relative abundances of OTUs corresponding to Fusobacterium nucleatum, Streptococcus parasanguinis II, and Neisseria species were significantly higher in tongue/pharyngeal cancer patients compared to their abundances in control subjects (P < 0.01). The relative abundance of an OTU corresponding to the Neisseria species was also significantly higher in gastric cancer patients and that of an OTU corresponding to Actinomyces odontolyticus was significantly higher in colorectal cancer patients (P < 0.01). These results suggest that the salivary microbiota might be associated with various digestive tract cancers.