The Value of Flexible Laryngoscopy in Diagnosis of an Unusual Laryngeal Foreign Body: Spiny Cocklebur (Xanthium Spinosum)

Abstract

Foreign body aspiration is a common and dangerous problem among children of all ages. Children under the age of three carry the highest risk for foreign body aspiration. Some cases may present with less severe symptoms or a misleading history that result in a false diagnosis and confusion. The emergency room physician should seek the advice of an experienced otolaryngologist in a child with an acute airway problem regardless of the history and examination. In this article, we present an 8-month-old boy with supraglottic laryngeal foreign body detected by awake flexible laryngoscopy. The patient presented with a history of manual strangulation by his 5-year-old brother and had stridor, tachypnea and persistent cough. Awake flexible laryngoscopic examination in the office yielded prompt diagnosis in a patient with confusing history and presentation. Spiny cocklebur was removed from his larynx by direct laryngoscopy. The clinical presentation of the patient and his management are discussed.