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We describe the case of a patient who swallowed a small fish bone and felt it lodge in her pharynx, but failed to seek medical attention in a timely manner. One week later, no foreign body was found in the hypopharynx or larynx, but a small purulent cyst was present in the epiglottic vallecula. A computed tomography scan showed a high-density area on the lingual surface of the epiglottis, which was considered to represent an embedded fish bone. A week later, the patient’s discomfort had subsided, and flexible videoendoscopy showed that the purulent cyst in the epiglottic vallecula had disappeared. We surmise that the purulent cyst had ruptured spontaneously and the foreign body had been discharged. This represents an example of how an impacted small foreign body may be spontaneously discharged from the body.

Objective: To systematically review the literature regarding the effectiveness and adverse reaction of epidermal growth factor receptor-monoclonal antibodies (RGFR-mAbs) in improving the prognosis of R/M HNSCC so as to develop evidence-based recommendations for treatment., Methods: Comprehensively searches were performed for the databases of CBM, PubMed, Embase and Cochrane to identify the published studies on the effect of RGFR-mAbs in recurrent and/or metastatic head and neck squamous carcinoma (R/M HNSCC) patients. Primary outcomes included overall survival (OS), progression-free survival (PFS) and overall response rate (ORR). And secondary outcomes included such severe adverse events (grade III-IV) as neutropenia, anemia, thrombocytopenia, skin reactions, hypokalemia, vomiting and hypomagnesemia, etc., Results: A meta-analysis was conducted for 5 randomized controlled trials involving a total of 1 615 patients. Pooled data suggested the efficacies of EGFR-mAbs in R/M HNSCC patients. And adding EGFR-mAbs to conventional therapy led to significantly improved efficacies for R/M HNSCC (ORR: RR=1.61, 95% CI: 1.34-1.92, P<0.001; PFS: HR=0.68, 95% CI: 0.61-0.76, P<0.001; OS: HR=0.84, 95% CI: 0.75-0.95, P=0.004). Adverse events were comparable between EGFR-mAbs and control groups, except for increased incidence in skin reactions, hypomagnesemia, anorexia, exsiccosis and thrombogenesis., Conclusions: Existing randomized controlled trials support the efficacies of EGFR-mAbs for R/M HNSCC. During Mabs therapy, skin reactions and hypomagnesemia should be closely monitored.

Objective: To perform a Meta-analysis of all randomized controlled trials that compared the efficacy and adverse events profile of Mabs for LA HNSCC., Method: Several databases were searched, including CBM, PUBMED, EMBASE, and CENTRAL. Primary outcomes included overall response rate (ORR), overall survival (OS), progression-free survival (PFS). Secondary outcomes included serious adverse events, such as grade 3-4 skin reaction, dysphagia, mucositis, and nausea/vomiting. The results were expressed as relative ratio (RR) or hazard rate (HR) with their corresponding 95% CI., Result: The final analysis included 10 trials. The primary analyses indicated that Mabs did not improve ORR and PFS, except OS for locoregionally advanced (LA) HNSCC [ORR 1.21, 95% CI (0.97 - 1.49); PFS 0.87, 95% CI (0.75 - 1.01); OS 0.82, 95% CI (0.71 - 0.95)]. Analysis of adverse effects demonstrated that grade 3 - 4 skin reaction ERR 1.87, 95% CI (1.11 - 3.16)] was statistically significantly associated with Mabs except dysphagia ERR 0. 95, 95% CI (0.75 - 1.19)], Mucositis ERR 1.03, 95% CI (0.67 - 1.57)], and nausea/vomiting ERR 1.15, 95% CI (0.71 - 1.86)]., Conclusion: Anti-EGFR Mabs may be satisfactory for improving OS of LA HNSCC. During the Mabs therapy, skin reaction should be much more monitored.