Ultrasound-Assisted Removal of a Wooden Foreign Body Embedded in the Neck

Objectives: The deep submucosal migration of ingested foreign bodies into the pharyngolaryngeal mucosa is a sporadic event, and its management can be very challenging. In the case of the failure of endoscopic retrieval, open surgical techniques are usually required, and intraoperative ultrasonography can become a useful adjunct for identifying their precise localization. Methods: An 84-year-old woman presented with new-onset dysphagia and odynophagia after the accidental ingestion of a fragment of a toothpick a few hours before in the absence of hoarseness or respiratory distress. Ultrasonography and an unenhanced CT scan of the neck revealed a 3 cm linear foreign body embedded into the neck between the left pyriform sinus and the esophageal wall. Results: We report the removal of a fragment of a wooden toothpick deeply lodged between the left pyriform sinus and the esophageal wall, which was managed via an open transcervical approach with the aid of intraoperative ultrasound guidance. Conclusions: We suggest that both preoperative and intraoperative ultrasonography should represent the first-line imaging technique for deeply embedded neck foreign bodies.