Cricoid plate ossification mimicking an impacted foreign body

Case contributed by Dr Ruwaida Bt Yaakub

Presentation

Foreign body sensation in throat and odynophagia for the past 2 weeks.

Patient Data

Age: 80 years old
Gender: Female

An elongated radiopaque structure at the level of C6 prevertebral region. Associated prevertebral soft tissue swelling noted.

Based on the lateral neck radiograph, impacted foreign body in the upper esophagus is highly suspicious.

There is calcification of the vertical plate of cricoid cartillage. The surrounding soft tissue are normal with no evidence of inflammation or abcess formation seen.
No evidence of impacted foreign body seen in the hypopharynx or upper esophagus.
Vocal cord is symmetrical.
Normal calcification of thyroid cartillage and arytenoid cartillage.

Case Discussion

Ossification of laryngeal cartilages is a physiological process, associated with advancing age. Ossification of the cartilages on the lateral neck plain radiograph may masquerade as impacted foreign body in the upper digestive tract in some patients with a history of foreign body ingestion. The other investigations to exclude the possibility of an impacted foreign body need to be performed which is CT scan should be the first choice for further investigations.

In our case, 70 degree scope had been performed on the patient and showed no evidence of impacted foreign body. In view of highly suspicious of impacted foreign body seen on lateral neck plain radiograph, CT scan was performed. Based on the CT findings, the vertical radio-opaque structure at C6 level is actually represent ossification of the vertical plate of cricoid cartilage.

The patient was treated with systemic antibiotics and symptoms were gradually resolved.

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Case information

rID: 58190
Published: 8th Feb 2018
Last edited: 9th Feb 2018
System: Head & Neck
Inclusion in quiz mode: Included

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