Backyard hazard: A case series of ingested grill brush bristles and a novel approach to extraction

Department of Otorhinolaryngology-Head and Neck Surgery, Albert Einstein College of Medicine, Bronx, NY, USA.
American journal of otolaryngology (Impact Factor: 0.98). 08/2012; 33(6). DOI: 10.1016/j.amjoto.2012.07.004
Source: PubMed


To report a small case series of an unusual ingested foreign body and a new method for removal of tongue base foreign bodies.

Three patients were identified with wire bristle foreign bodies between 2009 and 2011 at our academic tertiary medical center. Their medical records were reviewed and are described in this report.

Each patient presented to our medical center with progressive pain after ingestion of barbecued food. For 2 patients, the metallic bristle foreign body was imbedded within the lingual tonsil. In these 2 cases, radiofrequency plasma ablation (coblation) assisted partial lingual tonsillectomy was performed to identify the foreign body. In a third case, the foreign body presented as a complex deep space neck abscess and an open trans-cervical approach was required.

While oropharyngeal and esophageal foreign bodies are common, there are only a few case reports describing this particular foreign body. The presentation of an imbedded wire grill brush bristle can be insidious. Persistent pain and foreign body sensation should be taken seriously in patients with a history of barbecue food ingestion. Intraoperatively, wire bristles can be difficult to localize and extract. Radiofrequency plasma assisted lingual tonsillectomy may be helpful for identifying and removing foreign bodies that are imbedded in the tongue base. Grill brushes should undergo stringent safety regulation, as ingested wire bristles are difficult to localize and remove and may cause significant morbidity.

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    ABSTRACT: Wire brush bristles are an increasingly recognized hazard that can present as a foreign body in the aerodigestive tract. Due to their small size and tendency to become embedded in surrounding tissue, these small metallic bristles present a unique operative challenge to otolaryngologists. Here we present a case of a 40-year-old woman who underwent endoscopic extraction of a wire bristle from the posterior pharyngeal wall using suspension, microscopy, and C-arm fluoroscopy. We believe this is the first published case of an endoscopic removal of a buried foreign body in the hypopharynx using these methods of localization concurrently. By leveraging multiple techniques for visualization, surgeons can avoid open exploration while ensuring complete removal of the object. Additionally, this case highlights the importance of regulatory oversight and consumer awareness of the hazards of grill brushes.
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