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Lateral soft tissue neck X-rays: are they useful in management of upper aero-digestive tract foreign bodies?

Published online by Cambridge University Press:  15 August 2007

A Karnwal*
Affiliation:
Department of Head and Neck SurgeryDudley Group of Hospitals NHS Trust, UK
E C Ho
Affiliation:
Department of Head and Neck SurgeryDudley Group of Hospitals NHS Trust, UK
A Hall
Affiliation:
Department of Radiology, Dudley Group of Hospitals NHS Trust, UK
N Molony
Affiliation:
Department of Head and Neck SurgeryDudley Group of Hospitals NHS Trust, UK
*
Address for correspondence: Dr Abhishek Karnwal, 95 Kennet House, Bushey Fields Road, Dudley DY1 2LU, UK. Fax: 0044 1384 244169 E-mail: akarnwal@aol.com

Abstract

Objectives:

To assess the value of lateral soft tissue neck X-rays in patients presenting with upper aero-digestive tract foreign bodies.

Design:

Retrospective study.

Inclusion criteria:

(1) Patients referred to the ENT team, via either the accident and emergency department or their general practitioner; (2) a history of a non-aspirated, upper airway, aero-digestive tract foreign body; and (3) a lateral soft tissue neck X-ray taken on admission.

Results:

A total of 62 patients met the inclusion criteria. Twenty-four patients (38.7 per cent) had positive findings on lateral soft tissue neck X-ray. ‘Soft’ signs, such as widened pre-vertebral shadow and loss of lordosis, were seen in all 24 patients, and foreign bodies were visualised in six patients. Overall, lateral soft tissue neck X-rays were helpful in the management of 32 patients (51.6 per cent). Rather worryingly, doctors in the accident and emergency and ENT departments missed 79.2 and 66.6 per cent of the positive findings, respectively.

Conclusions:

A lateral soft tissue neck X-ray is a helpful tool in the management of patients presenting with upper aero-digestive tract foreign bodies. Junior doctors need better radiology training.

Type
Main Article
Copyright
Copyright © JLO (1984) Limited 2008

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Footnotes

Presented at the Midlands Institute of Otology meeting, 5 January 2007, Stoke on Trent, UK.

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