Foreign body injuries carry a risk of acute and potentially life-threatening complications such as bleeding, airway compromise, and neurovascular injury. A 19-year-old female presented to the Otorhinolaryngology Department. Patient Concerns: Pain over the right side of the neck below the angle of the mandible following a fall on a pin cushion after a fight with her brother. She reported that the wound might have been caused by a sewing needle lodged in the pin cushion. Clinical examination: It revealed an abrasion (4 mm × 3 mm) about 2 cm below the mandibular body margin at the anterior border of the sternocleidomastoid muscle [Figure 1]. Clinically, tenderness was present around the wound site. Diagnosis: X-ray soft-tissue neck lateral view revealed a radiopaque linear shadow on the right side of the neck at the level of the C1-C2 vertebrae. On contrast-enhanced computed tomography, a linear (needle-like) foreign body at the level of C1-C2 was approximately 1.6 cm deep from the skin. The internal jugular vein seemed to be compressed between the needle and vertebrae. Treatment: Foreign body was explored and removed under general anaesthesia by an open lateral cervical approach. Multiple C arm X rays were done to locate and confirm the site of the foreign body intraoperatively. Outcomes: The patient’s postoperative recovery was uneventful. Take-away Lesson: Due to early diagnosis, management, and a team of experienced surgeons, anaesthesiologists, and support staff, any morbidity or mortality was avoided. 

Dr. Himani Singh has completed her MBBS from Sharda University and MS ENT with a Gold Medal at the age of 27 years from Chaudhary Charan Singh University, India. Currently she is working as a Senior Resident at Subharti Medical College, Meerut, India. She has 5 publications in a span of 2 years of her career. She has participated in various national and state otorhinolaryngology conferences. She has also been part of several temporal bone dissection workshops.