Persistent Fish Bone Sensation in Throat: When to Seek Further Medical Evaluation?

Fish bone stuck in the throat?

Hello Doctor: Three weeks ago, I accidentally inhaled a fish bone while eating a thinly grilled salmon.
The bone is less than 1 cm long.
I urgently went to a nearby hospital and informed them of the approximate location of the bone (about 1 cm above the Adam's apple on the right side).
On that day, a nasopharyngoscopy was performed, but the fish bone was not found.
An X-ray was taken, which showed a "suspected" small fragment adhering to the esophageal wall.
I was then referred for an endoscopy, but the endoscopist also did not find the fish bone.
During the second and third weeks, I still felt the sensation of having a fish bone in my throat and naturally vomited three times (not induced), without any fever.
In the third week, feeling very uncomfortable, I visited a hospital closer to home, where a nasopharyngoscopy was again performed, but no fish bone was found.
I still feel a sensation of a fish bone and pain when lightly pressing the area about 1 cm above the Adam's apple on the right side.
I experience the same sharp pain when looking up, eating, or swallowing saliva.
Occasionally, turning my head causes a stabbing pain that radiates to my ear.
I can still breathe and eat normally, but my appetite is poor.
Since this has been ongoing for three weeks, I would like to know if I should continue to self-monitor, or if I should arrange for further examinations (such as a CT scan)?

Da Hei Tan, 20~29 year old female. Ask Date: 2020/11/08

Dr. Zheng Jueyi reply Otolaryngology

Hello, if you continue to feel unwell, it is advisable to return for a follow-up examination.
As for what tests need to be arranged, that will depend on clinical judgment.
Wishing you safety and health.
Sincerely, Dr.
Cheng Jue-Yi, Director of the Department of Otolaryngology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2020/11/08

More Info

It sounds like you are experiencing a persistent sensation of a fish bone lodged in your throat, which has been ongoing for three weeks despite multiple medical evaluations. This situation can be quite distressing, and it's understandable that you are seeking further guidance.

Firstly, it is important to note that the sensation of a foreign body in the throat can sometimes persist even after the object has been removed or is no longer present. This phenomenon is often referred to as "foreign body sensation" and can be caused by irritation or inflammation of the tissues in the throat, which may occur after an object like a fish bone has been lodged there, even if it has since been removed.

Given your history, here are some considerations regarding your symptoms and the next steps you might take:
1. Persistent Symptoms: Since you have been experiencing this sensation for three weeks, it is advisable to seek further medical evaluation. While initial examinations (nasopharyngoscopy and endoscopy) did not reveal any fish bone, the ongoing discomfort and sensation warrant a more thorough investigation.

2. Further Imaging: A CT scan of the neck may be beneficial in this case. It can provide a more detailed view of the throat and surrounding structures, potentially revealing any inflammation, abscess formation, or other abnormalities that might not have been visible on previous examinations.

3. Possible Complications: While it is good that you are able to breathe and swallow normally, the pain radiating to your ear and the sensation of something being stuck could indicate irritation or inflammation of the surrounding tissues. In some cases, if a foreign body is not removed, it can lead to complications such as infection or abscess formation.

4. Management of Symptoms: In the meantime, managing your symptoms is important. Staying hydrated, using warm saltwater gargles, and possibly taking over-the-counter pain relief medications may help alleviate some discomfort. However, these are temporary measures and do not replace the need for further evaluation.

5. Follow-Up with a Specialist: If you have not already done so, consider consulting an Ear, Nose, and Throat (ENT) specialist. They can perform a more comprehensive evaluation and may have access to specialized imaging techniques or procedures that can help identify the cause of your persistent symptoms.

6. Monitoring for Changes: Keep an eye on any changes in your symptoms. If you experience increased pain, difficulty swallowing, fever, or any other concerning symptoms, seek immediate medical attention.

In summary, while self-observation is a reasonable approach for a short period, given the duration and nature of your symptoms, it is advisable to pursue further medical evaluation. A CT scan and consultation with an ENT specialist could provide valuable insights and help determine the best course of action for your recovery. Your health and comfort are paramount, and addressing these ongoing symptoms is important for your overall well-being.

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