Foreign matters of a throat — the alien objects, parts of food or live organisms which in a random way got into a throat. Foreign matters of a throat make the damaging impact on its mucous, can become the reason of infection and lead to an obturation of the top airways with development of asphyxia. Foreign matters of a throat are shown by the expressed sore throat, irritation, feeling of a foreign matter, the swallowing violation increased by salivation, desires to vomiting. Difficulties of breath and asphyxia can be observed. Diagnostics of foreign matters of a throat is based on anamnestichesky yielded, results of a faringoskopiya and a radiological research. Medical tactics consists foreign matters of a throat in the natural way or in a surgical way at a distance.
Foreign matter of a throat
The throat performs barrier function, interfering with passing of the foreign matters which got to it is farther in airways or a digestive tract. It is carried out due to reduction of muscular presses of a throat which reflex happens in response to perception of a foreign matter sensitive receptors of a mucous membrane. If the subject which got into a throat breaks its protective barrier, then there is a foreign matter of a gullet or a foreign matter of a throat. At a strong kashlevy push the alien subject can be thrown from a throat in a nasal cavity with formation of a foreign matter of a nose.
Most often the carelessness in the course of meal, laughter and a conversation is the reason of hit of foreign matters in a throat during food. Small household objects can get into a throat with food or slip out incidentally when keeping by their lips. At small children foreign matters of a throat arise through an oversight of adults. The elderly people having removable dentures in the period of a dream can have a drop-out of an artificial limb in a throat cavity. Mistakes of medical personnel when performing manipulations in an oral cavity or a nose can lead to hit in a throat of parts of medical tools, wadded tampons, etc. Live organisms get into a throat with not boiled drinking water, the inhaled air or retrogradno from the patient's intestines.
Classification of foreign matters of a throat
In an anatomic structure of a throat allocate 3 parts: top — a nasopharynx, average — a rotoglotka and lower — a gortanoglotka. Foreign matters of a throat classify in dependence because in what its part they are. As a rule, foreign matters of a rotoglotka and a gortanoglotka meet. Localization of a foreign matter in a nasopharynx is observed in rare instances and is usually connected with paralysis of a soft palate which cause pathological processes of a trunk of a brain can be (an ischemic and hemorrhagic stroke, a siringomiyeliya, tumors, neurosyphilis and so forth).
In character foreign matters of a throat can be household, food, yatrogenny, live. Most often the foreign matters of a throat representing parts of food meet: fish and meat stones, badly chewed pieces of meat. Among household foreign matters of a throat nails, screws, sewing needles, buttons, hairpins, dentures, coins, pieces of glass or a tree, small toys or their details are usually observed. Wadded tampons, tooth drills, fragments of the medical needles and other tools used in stomatology, otolaryngology and surgery can become Yatrogenny foreign matters of a throat. Hit of alien objects in a throat is possible during removal of teeth, treatment of caries, prosthetics of teeth, removal of benign tumors of a throat and cavity of a nose, carrying out an adenotomiya, tonzillektomiya and other operations. The ascarids getting from intestines, bloodsuckers getting into a throat with water from open reservoirs during the bathing or drink and also various insects whom the person incidentally inhales together with air treat live foreign matters of a throat. Foreign matters of a throat also consider the petrifikata which are formed by a kaltsifikation of kazeozny contents of crypts of palatal almonds (like petrifikata in radical lymph nodes at tuberculosis of lungs).
By origin foreign matters of a throat subdivide on exogenous and endogenous. Exogenous foreign matters of a throat get into it outside through a mouth or a nose. Endogenous foreign matters of a throat are formed directly in it or get into a throat in the ascending way. The petrifikata which are formed in crypts of palatal almonds and the ascarids through a stomach and a gullet migrating in a throat from intestines concern to them. On depth of penetration into throat tissues in otolaryngology it is accepted to divide the superficial and deeply getting foreign matters of a throat.
Symptoms of foreign matters of a throat
The clinical picture of foreign matters of a throat depends on their sizes, a look, form and arrangement, and also on time which passed from the moment of their hit in a throat. The general symptoms are: a sore throat, feeling of a foreign matter, irritation, cough, swallowing difficulty, the strengthened salivation. Irradiation of pain in an ear or a throat can be observed. At localization of a foreign matter in a rotoglotka are noted a desire to vomiting. In certain cases the subject which got into a throat passes in a gullet or a throat, injuring at the same time mucous drinks that is also shown by pain and irritation in a throat.
Sharp objects are usually localized in a rotoglotka, getting stuck in handles and lacunas of palatal almonds or an almond of a root of language. Sharp foreign matters of a throat cause sharply expressed pain syndrome. The pain of the cutting or pricking type amplifying at a conversation, swallowing and even the respiratory movements is characteristic. Sharp foreign matters of a throat can become the reason of a spasm of muscles of a throat in this connection the patient is not able to make the glotatelny movements, so to eat food and to drink water. Violation of swallowing because of severe pain or a spasm of muscles leads to the fact that saliva is not swallowed, and follows from an oral cavity, leading to maceration and an inflammation of lips.
Stupid foreign matters of a throat often pass in a gortanoglotka and settle down over an entrance to a throat or a gullet. Large foreign matters of this localization can partially block a throat gleam, leading to breath violations. The full obturation of an entrance to a throat causes asphyxia — the termination of intake of air in airways. Elastic foreign matters of a throat (for example, particles of meat food) which, unlike firm objects, when filling a gortanoglotka do not leave cracks through which there could pass air happen the reason of asphyxia more often.
Complications of foreign matters of a throat
Even the insignificant travmatization mucous a foreign matter of a throat leads to development of inflammatory reaction with aggravation of a pain syndrome, developing of hyperaemia and hypostasis. The expressed puffiness narrows a gleam of an entrance to a throat and causes difficulties of breath and swallowing. The foreign matters of a throat having acute angles or pricking parts are capable to cause deep and considerable damages of tissues of throat (a throat injury). They can lead to bleeding from the injured throat vessels.
Foreign matters of a throat can be an infection drift source. Formation of side abscess of a throat, paratonzillyarny or zaglotochny abscess, development of phlegmon of a neck is as a result possible.
Diagnostics of foreign matters of a throat
The foreign matters of a throat located in its middle part — a rotoglotka, are usually diagnosed without difficulties as are well visible at survey and palpated at a manual research of a throat. The small foreign matters of a throat or objects which deeply took root into folds of a mucous membrane are badly visualized. Alien bodies in the field of a gortanoglotka, especially are also badly visible when they are localized around cherpalovidny folds, between a nadgortannik and a root of language, in pear-shaped sine. Apply a faringoskopiya to the best visualization of foreign matters of a throat. In certain cases conduct a radiological research. At suspicion on migration of a foreign matter in a nasal cavity, a throat or a gullet the rinoskopiya, a laringoskopiya, an ezofagoskopiya and a X-ray analysis of a gullet with contrasting is shown.
Approximately in half of cases at the address of patients concerning foreign matters those drinks are not found. At the same time traces of the traumatizing a throat caused by attempts to remove a foreign matter which can be swallowed usually come to light or at all be absent. Complaints to nonexistent foreign matters of a throat can be caused by inflammatory processes (tonsillitis, pharyngitis), throat tumors, psychoneurological violations, excessive suspiciousness of the patient. In some cases feelings of a foreign matter of a throat are connected with pathological changes of cervical vertebras (osteochondrosis, ), lengthening of an awl-shaped shoot, dysfunction of the neuromuscular device.
Removal of foreign matters of a throat
Foreign matters of a throat are subject to removal. If they are well visualized and are readily available, then their removal is carried out by the otolaryngologist in the conditions of polyclinic handling. Withdrawal of such foreign matters of a throat is made with use of tweezers, Bryunings's nippers or a nasal korntsang. After removal of a foreign matter the throat is processed Lugol solution, recommend to the patient food soft food and rinsings by solutions of anti-septic tanks.
More difficult the foreign matters of a throat located in its guttural part are removed. Their withdrawal is carried out under local anesthesia, for reduction of salivation before removal atropine is entered. The guttural mirror and special guttural nippers are applied. Remote foreign matters are removed by means of a laringoskopiya. The foreign matters of a throat which took root into soft fabrics, or badly taken because of the expressed hypostasis often cannot be taken in the natural way. In such cases make surgical removal by means of opening of a throat — faringotomiya.
The foreign matters of a throat leading to the expressed violations of breath and asphyxia life-endangering the patient demand urgent removal. It is made in the manual way at once on the scene.