Objective: To report a case of hoarseness in a child due to misdiagnosed and neglected laryngeal chicken bone impaction and to discuss its clinical manifestations, clinical course, ancillary procedures, and management.

Setting: Tertiary Government Training Hospital

Patient: One

Results: E.P., 8-year-old female was admitted with one month history of chicken bone impaction in the glottic area. The patient noted foreign body sensation in the throat after eating rice porridge. She consulted and was discharged from a hospital since the chest and neck x-rays were unremarkable. A week later, she developed hoarseness, shortness of breath and productive cough. Repeat chest x-ray was negative with a diagnosis of upper respiratory tract infection. Medications afforded no relief and

persistence of symptoms prompted consult at our institution. From the ER, she was brought to the operating room however she developed laryngospasm and desaturation hence the procedure was postponed on the following day. Under general anesthesia, direct laryngoscopy showed a V-shaped chicken bone lodged in the glottic chink which was removed with uneventful recovery.

Conclusion: Foreign body in the laryngeal inlet is a life-threatening condition which may compromise the airway. Radiographs is not reliable in cases of small foreign body which may appear radiolucent and overlaps with the bony and cartilaginous cervical and laryngeal framework. This case underscores the importance of early diagnosis, high index of suspicion based on history and clinical endoscopy for prompt removal of the

foreign body to prevent complications and morbidity.

Keywords: chicken bone impaction, glottic area, laryngospasm, video laryngoscopy

Dr. Katrina Nicole P. Fortuno is currently a licensed resident physician in the Department of Otorhinolaryngology-Head and Neck Surgery at Quezon City General Hospital. She graduated with a Doctor of Medicine degree from De La Salle Health Sciences Institute in June 2019 and successfully passed her physician licensure exam in November 2020. She obtained her undergraduate degree at the University of Santo Tomas, major in Medical Technology, and a board passer in that field. Recently, her case report, titled "Hoarseness due to misdiagnosed and neglected laryngeal chicken bone impaction," published in the Journal of Laryngology and Voice last October 2023.