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The utility of lateral neck radiographs in the management of fish bones

Published online by Cambridge University Press:  19 November 2019

T Pitts-Tucker ,
T C Biggs  and
N N Patel
T Pitts-Tucker*
Affiliation:
Department of Surgery, University Hospital Southampton NHS Foundation Trust, UK
T C Biggs
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, University Hospital Southampton NHS Foundation Trust, UK
N N Patel
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, University Hospital Southampton NHS Foundation Trust, UK
*
Author for correspondence: Mr Toby Pitts-Tucker, Department of Surgery, University Hospital Southampton NHS Foundation Trust, Tremona Road, SouthamptonSO16 6YD, UK E-mail: tobypittstucker@gmail.com
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Abstract

Background

Lateral neck radiographs are commonly used in the investigation and management of patients presenting with suspected fish bone impaction. The effectiveness of these is questioned, as many fish do not have radio-opaque bones.

Objective

This study evaluated the utility of lateral neck radiographs in the management of patients presenting with fish bones retained in the upper aerodigestive tract, with the creation of a treatment algorithm to guide further management.

Methods

An audit of practice was undertaken at the University Hospital of Southampton, identifying all patients admitted with potential fish bone impaction in the upper aerodigestive tract. Following analysis, a treatment algorithm was constructed for use by junior doctors.

Results

In total, 34 per cent of patients with a normal radiograph were subsequently found to have a fish bone present under local or general anaesthetic assessment. The sensitivity of radiographs in the detection of fish bones was found to be 51.6 per cent.

Conclusion

Lateral neck radiographs have limited value in the management of suspected fish bone impaction, and should only be used following detailed clinical examination of the upper aerodigestive tract.

Keywords

HumansHospitals, UniversityRadiographyAlgorithmsOtolaryngology
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 133 , Issue 12 , December 2019 , pp. 1064 - 1067
Copyright
Copyright © JLO (1984) Limited, 2019

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Footnotes

Mr T Pitts-Tucker takes responsibility for the integrity of the content of the paper

References

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