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Retrieving Oropharyngeal Stick Foreign Bodies

Clinician's Brief (Capsule)

Surgery, Soft Tissue

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November 2015

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Acute oropharyngeal stick injuries (OSIs) are relatively common in dogs. Surgical removal and debridement are usually recommended. This retrospective case study described the use of rigid endoscopy in the diagnosis and treatment of canine OSIs. Nine dogs presented within 1 to 3 days of injury with clinical signs including oral pain, oral bleeding, lethargy, coughing, hypersalivation, and/or choking. Obvious oropharyngeal wounds were present in each case. 

Dogs were anesthetized and—after manual removal of the stick foreign body if present (n = 2)—the wound tract was explored using a 30o forward-oblique, 2.7-mm-diameter, 18-cm-length rigid endoscope with a 14.5 Fr sheath. The wound was irrigated with saline, and any foreign materials >1 mm in size were retrieved using grasping forceps. Macroscopic foreign material was recovered in all cases. Tracts were then reinspected, flushed, and allowed to heal by second intention. Dogs were placed on broad-spectrum oral antibiotics and nonsteroidal anti-inflammatories and discharged within 24 hours. All dogs recovered free of complication over the follow-up interval (7 to 29 months). Shortcomings of this technique include the cost and technical expertise required as well the possible need for surgical intervention should the wound tract prove too extensive. The lack of an open oropharyngeal wound in chronic OSIs likely precludes the use of rigid endoscopy in chronic cases. The authors conclude that rigid endoscopy, a less invasive alternative to surgery, can be an effective means of exploring and potentially managing acute OSIs in dogs.

Commentary

Nine dogs were retrospectively evaluated after a rigid endoscope was used to remove sticks from the oropharyngeal area. All dogs had the foreign material successfully removed and recovered uneventfully. This study described a technique that is less invasive than surgical intervention and resulted in complete resolution of the traumatic injury. The endoscopy procedure was found to take a minimal amount of time and produced less tissue damage, thus leading to decreased hospitalization time. With experienced use, endoscopy can be a successful alternative treatment to remove oropharyngeal stick foreign bodies in dogs.—Lisa L. Powell, DVM, DACVECC

References

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