title: Nasopharynx- The Secret Vault for Lost Foreign Bodies of the Upper Aerodigestive Tract.
abstract: BACKGROUND
  Foreign bodies in the upper aerodigestive tract often get lost following inappropriate attempts at removal. Children may present late with localized infection, posing a challenge to the otolaryngologists in a referral set-up in diagnosing and retrieving such foreign bodies.
  
  
  METHODS
  A two-year-old boy presented with refractory purulent rhinorrhea and intermittent low-grade fever. The symptoms suggested rhinosinusitis; however, following a high index of suspicion, he was referred for further evaluation, with the possibility of any hidden foreign object in the upper aerodigestive tract. His soft palate appeared bulged, and his mother informed that he had ingested the cap of a plastic bottle about a month back which could not be retrieved despite several attempts by her. X-ray of soft tissue nasopharynx revealed a radiolucent shadow of a round object resulting in palatal bulging. It was eventually removed by combined endoscopic/transoral approach.
  
  
  CONCLUSIONS
  In a child with a lost foreign body, the nasopharynx should be meticulously explored. This is less common for ingested objects compared to inhaled ones. The diagnosis becomes furthermore challenging when it is not radio-opaque. Naïve manipulations must be avoided and prompt referral should be made to the otolaryngologists for guided removal and minimizing complications.
authors.affiliation: Department of Otorhinolaryngology and Head-Neck Surgery; ICARE Institute of Medical Education and Research. Banbishnupur West Bengal, India.
authors.forename: Arijit
authors.initials: A
authors.lastname: Jotdar
authors.affiliation: Department of Otorhinolaryngology and Head-Neck Surgery, Medical College and Hospital, Kolkata 88, College Street, Kolkata - 700073, West Bengal, India.
authors.forename: Mainak
authors.initials: M
authors.lastname: Dutta
authors.affiliation: Department of Otorhinolaryngology and Head-Neck Surgery, Medical College and Hospital, Kolkata 88, College Street, Kolkata - 700073, West Bengal, India.
authors.forename: Sohag
authors.initials: S
authors.lastname: Kundu
keywords: Foreign body; Ingested; Nasopharynx; Radiolucent