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The Federal Aviation Administration (FAA) is developing new design procedures to extend airport pavement life beyond 20 years based on the concept of serviceability: the measure of how well a pavement fulfills user expectations. A key element is a new distress megaindex called serviceability level (SL) whose components represent independent aspects of airport pavement serviceability: low foreign object damage (FOD) potential, low skid potential, and smoothness. This research validates the assumption of independence previously used to develop a probability-based form for SL. Independence greatly simplifies the mathematics of the new form, in particular, the ability to decompose a pavement condition model into multiple relatively simple submodels. Friction is shown to not correlate to the other two components. FOD and roughness are conditionally independent with a latent variable of crack and spall density. Conditional independence means the proposed SL formulation is generally valid but requires that FOD and roughness measurements or predictions be made at the same time using the same assumptions. [ABSTRACT FROM AUTHOR]

Upper airway obstruction can occur suddenly and result in a patient's rapid deterioration. In this article we provide a structured approach to identifying those patients with acute airway compromise and stratifying them according to clinical urgency. This includes ways of distinguishing both the level of obstruction and its severity, based on the clinical signs and symptoms, and the role and timing of investigations. We describe the key aspects of emergency management, including temporizing measures and airway adjuncts. Management of rare, but important, situations are discussed such as post-thyroidectomy haematoma, occlusion of tracheostomy and laryngectomy stomas, and post-obstruction pulmonary oedema (POPE) is discussed. We describe the situation when an emergency surgical airway should be considered, along with our technique of performing one. [ABSTRACT FROM AUTHOR]

Although paediatric patients with gastrointestinal (GI) foreign bodies require multiple resources, they often present with few or no discernible symptoms and are typically assigned a low acuity level during triage. We compared the predictive accuracy of the revised Korean Triage and Acuity Scale (rKTAS), which elevates acuity by one step in relation to anticipated resource utilization, with that of the conventional KTAS for clinical outcomes. This was a retrospective study of National Emergency Department Information System data. Data on patient and ED characteristics, resources used, and clinical outcomes were collected from January 2018 to December 2021 for patients with GI foreign bodies aged under 19. The primary outcome was rKTAS accuracy in predicting hospitalization, ICU admission, operating room (OR) use, and ED length of stay (EDLOS). The AUROC was used to evaluate the performance via of the KTAS and rKTAS. In total, 25,324 paediatric patients visited the ED for GI tract foreign bodies. The mean age was 3.8 years, and 51% (12,923) were between 1 and 4 year old. Although most (23,658; 93.4%) were discharged, 4.9% required hospitalization. Two or more resources were utilized in 2514 (9.9%) cases, and 3,514 individuals had their triage levels increased by one step. Compared with those of the KTAS, the AUROCs of the rKTAS for predicting overall hospitalization (p < 0.05), admission to general wards (p < 0.05), ICU admission (p = 0.01), and admission via the OR (p < 0.05)were higher than KTAS. Compared with that with the KTAS, the EDLOS with the rKTAS was longer at levels 1, 2, and 3. The adjusted rKTAS is a better predictor of clinical outcomes for paediatric patients with GI tract foreign bodies than the KTAS. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to assess the effectiveness of capsule endoscopy in detecting gastric foreign bodies in normal dogs, considering variations in the number of foreign bodies and the gastric environment. Methods: Five healthy male beagles were administered virtual, non-harmful foreign objects that maintained their shape in the stomach. Capsule endoscopy was performed and the images were evaluated by veterinarians and nonveterinarians. Results: The overall sensitivity and specificity of capsule endoscopy were 99.1 and 90.4%, respectively. Sensitivity and specificity were comparable between veterinarians and non-veterinarians. Sensitivity and specificity in the veterinarian group were 98.7 and 91.2%, respectively, whereas those in the non-veterinarian group were 100 and 88.5%, respectively. Discussion: Capsule endoscopy is a valuable alternative diagnostic tool for identifying foreign bodies in the stomach, particularly in challenging cases in which conventional imaging or invasive approaches have limitations. [ABSTRACT FROM AUTHOR]

Introduction: This case report reports an unusual occurrence of gossypiboma, which refers to the accidental retention of surgical materials like sponges in the peritoneal cavity. The term is derived from "gossypium" (cotton) and "boma" (place of concealment). Its incidence varies with surgical type, posing diagnostic challenges due to nonspecific symptoms and equivocal imaging. Despite its rarity, gossypiboma poses significant risks, including intestinal obstruction and abscess formation. Case presentation: A 37-year-old woman with ten previous pregnancies and an emergent caesarean section presented with abdominal pain. Examination and ultrasound suggested an ovarian cyst. During surgery, a 10 × 10 cm gauze-filled mass adherent to the ovary and jejunum was found. Postoperatively, she recovered well with no complications. The patient was treated with intravenous fluids and antibiotics for five days post-surgery and recovered without any complications. She was discharged from the hospital five days after the procedure. Conclusion: To the best of our knowledge, this is the first reported case of gossypiboma in Sudan in 2024, highlighting diagnostic challenges and the need for preventive protocols. Root cause analysis of accidents, enhanced training, application of advanced technologies and a collaborative culture in the operating room can prevent the occurrence of such incidents. This case underscores the importance of meticulous surgical protocols and continuous improvement in safety measures to prevent retained surgical items, ensuring patient safety and optimal outcomes. [ABSTRACT FROM AUTHOR]

Background: Ingestion of foreign bodies may be seen unconsciously or intentionally in patients with mental health problems. Most cases pass through the esophagus slowly; however, in some cases, the tumor may be located in narrower areas of the digestive tract that require endoscopic or surgical intervention. This study describes a rare case of successful removal of more than 450 pieces of metal objects from the stomach of a 36-year-old man via ingestion of foreign bodies at Imam Khomeini Hospital in Ahvaz. Case presentation: A 36-year-old male patient (Aryan race) presented with complaints of chronic abdominal pain, frequent vomiting, and intolerance to liquids and food. The patient's companions mentioned a history of gradual ingestion of small metal objects 3 months prior. The patient was conscious and had stable vital signs. In the patient's X-ray and endoscopy, multiple metal objects inside the patient's stomach were observed, causing gastric outlet obstruction. The patient underwent gastrostomy surgery, and 452 screws, nuts, keys, stones, and other metal parts weighing 2900 g were removed from the stomach. Five days after the operation, the patient was transferred to the psychiatric service in good general condition and was diagnosed with psychosis, and her condition returned to normal at follow-up. Conclusion: Successful removal of this foreign body is rare. In chronic abdominal pain, especially in the context of psychiatric disorders, attention should be given to the ingestion of foreign bodies. In swallowing large amounts of sharp and metallic foreign objects, surgical intervention is necessary, especially in cases of obstruction, and saves the patient's life. [ABSTRACT FROM AUTHOR]

Objective: Unusual clinical course Background: Foreign body aspiration (FBA) is a common and serious problem in childhood that requires early recognition and treatment. Common complications include asphyxia, hemorrhage, infection, and pneumothorax. In severe cases of foreign body obstruction, death can result from asphyxia. We report an interesting case in which a forgotten cotton ball was inhaled into the lungs. Case Report: A 5-year-old boy presented to the local hospital with coughing for 6 days and fever for 4 days, without any information of foreign body aspiration upon admission. Laboratory findings indicated an elevated white blood cell; therefore, cefprozil was given as anti-infective treatment. However, the child’s condition did not improve. A computed tomography scan showed left pulmonary atelectasis. Considering that the child’s condition was serious, he was referred to our hospital for diagnosis and treatment. After referral, auscultation revealed decreased breath sounds over the left lung. After multidisciplinary discussion, combined with the results of auxiliary examination, the possibility of a foreign body was considered. He underwent rigid bronchoscopy, which confirmed a yellow-white foreign body in the left main bronchus that was later verified as a cotton ball. The operation was very successful. Eventually, his condition improved and he was discharged, without additional complications. Conclusions: For children with unclear history of foreign body aspiration, bronchoscopy is recommended if there is recurrent pulmonary infection, low auscultation breath sounds, or abnormal imaging. The choice of surgical method depends on the location and type of foreign body and the experience of the surgeon, which is also very important. [ABSTRACT FROM AUTHOR]

Purpose: Ocular emergencies require immediate intervention to prevent rapid vision loss or functional impairment. The aim of this study was to determine the proportion of true ocular emergencies among patients who presented to the general emergency department with ocular complaints and were referred to the Eye Clinic. Methods: In a retrospective cross-sectional study in a tertiary hospital in Istanbul, patients aged 0–100 years who presented to the general emergency department with ocular complaints between January and December 2022 were included. Inconclusive diagnoses and incomplete records were excluded. Patients were divided into three groups: top eye emergencies (TE), relative eye emergencies (REE), and non-emergency eyes (NEE). Results: Among the 652,224 individuals seeking care, 9,982 (1.5%) were referred to the Eye Emergency Clinic. Of these, 2,788 (27.9%) were female, and 7,194 (72.1%) were male, with ages ranging from 0 to 98 years. TopEye Emergencies (TEE), Relative Eye Emergencies (REE), and Non-Eye Emergencies (NEE) accounted for 13%, 60%, and 27% of the cases, respectively. Common top-eye emergencies (TEE) include chemical injuries, orbital-preseptal cellulitis, and orbital fractures. Relative eye emergencies (REEs) commonly feature corneal foreign bodies, corneal erosion, and conjunctivitis. Nonemulsion eye (NEE) methods involve simple eye redness, trauma without eye involvement, and subconjunctival haemorrhage. Conclusions: Consistent with the literature, 1.5% of patients presenting to the general emergency department had eye complaints.However, 27% of those referred to the ophthalmological clinic did not have an urgent eye condition. This is partly due to the high proportion of patients presenting to the emergency department with ocular complaints and the lack of knowledge of ophthalmological diseases by emergency physicians, leading to unnecessary referrals to the ophthalmology clinic, resulting in a loss of the workforce and reduced time allocated to patients with true ocular emergencies. [ABSTRACT FROM AUTHOR]

Subcutaneous nodular lesions in a patient with significantly elevated inflammatory markers always raise the possibility of infectious diagnoses such as atypical infection, pyogenic abscess, mycobacterial infection, and malignancy. Definitive diagnosis requires tissue biopsy and histopathologic examination. The atypical presentation of a foreign body granuloma with concurrent intraoperative findings supports the diagnosis of gouty arthritis. We report a case of a 67-year-old man who presented with an inflammatory nodular lesion on the left elbow that was initially suspected to have an infectious cause. Histopathologic examination of the nodular tissue later revealed that the patient had a foreign body granuloma due to urate crystal deposition. The atypical appearance of the gouty arthritis, the low serum urate level, the negative crystal identification in the synovial fluid, and the markedly elevated inflammatory markers, which did not respond to the previous antibiotic and steroid therapy, raised the suspicion of atypical infection in this case. [ABSTRACT FROM AUTHOR]

OBJECTIVE To retrospectively report the historical and clinical findings, diagnostics, treatment, and outcome of horses with penetrating wood foreign bodies (PWFBs) of the coronary band. ANIMALS 15 client-owned horses. CLINICAL PRESENTATION Horses had varying degrees of lameness and soft tissue swelling of the coronary band and pastern region. A defect in the coronary band was identified, but the actual wood foreign body was not always readily visualized. RESULTS Medical records of horses diagnosed with PWFBs of the coronary band between 2004 and 2023 were reviewed. Information retrieved from the medical records included history, signalment, diagnostics, treatment, and outcome. Thirteen of 15 horses that sustained a PWFB to the coronary band were participating in foxhunting. Penetrating wood foreign bodies occurred more frequently near the central axis or toe region (11/15) and more commonly in the forelimbs (11/15). Removal of PWFBs can be performed with the horse standing and sedated with regional anesthesia. Complete removal of the PWFB required partial removal of the adjacent hoof wall. CLINICAL RELEVANCE Penetrating wood foreign bodies occurred in the coronary band and lodged distally in the hoof wall of horses. Foxhunting may be a risk factor for this type of injury. Penetrating wood foreign bodies occurred most commonly in the front feet, near the central axis of the coronary band. Complete removal of the PWFB required removing a section of the adjacent hoof wall. The prognosis for return to the previous level of activity following treatment was favorable. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Accidental foreign body ingestion is the most common hidden cause of abdominal pain. A high index of suspicion should be implemented in patients with unresolved abdominal pain. Here we reported a 54‐year‐old patient with vague abdominal pain who had a successful laparoscopic removal of a toothpick. Toothpicks and fish bones are considered one of the most common accidentally ingested foreign bodies. Fortunately, most patients are asymptomatic. About 80%–90% of ingested foreign bodies pass through the gut spontaneously within a week. We present a case of a 54‐year‐old female with chronic epigastric pain and fever found to have a foreign body (toothpick) that penetrated the stomach and migrated to the liver causing liver abscess with portal vein thrombosis. The patient was managed with laparoscopic removal of the foreign body with an uneventful postoperative course. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Foreign bodies such as bone with a sharp end can penetrate the esophageal wall and lie extramurally. When a foreign body is not found on rigid oesophagoscopy, reassessing with imaging is important. The transcervical approach is a better alternative for such patients to remove the foreign bodies. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Foreign body aspiration is common in old age, sometimes lodged in unusual locations like the left upper lobe bronchus when aspiration happens in a recumbent position. Computed tomography is the preferred diagnostic tool, while flexible bronchoscopy is effective for removing the foreign body. Tracheo‐bronchial foreign body aspiration (FBA) is common in children and elderly, but often goes unnoticed due to vague symptoms and atypical imaging findings. We present a case of aspiration of pea in elderly presenting with acute symptoms. Computed tomography (CT) reveled an atypical site of foreign body (FB), that is left upper lobe bronchus and immediate removal of the FB was done using a flexible bronchoscope. The symptoms subsided after removal of the FB. Missed FBs can lead to chronic issues like pneumonia and airway obstruction. Advanced age, psychiatric illness, stroke, seizure disorder, and neuromuscular disease increase the risk of aspiration in older adults. Commonly, FBs get lodged in the right middle and lower lobes after aspiration due to vertical orientation of the airways. CT is a helpful tool for diagnosis of FBA and flexible bronchoscopy is effective in removal of the FB in elderly. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Perforation of Meckel's diverticulum (MD) is rare, particularly by foreign body. High index of suspicion and thorough intraoperative assessment is needed in patients undergoing surgery for acute appendicitis, specifically when appendix appears normal. Meckel's diverticulum is the most common congenital anomaly of the gastrointestinal tract. While often asymptomatic, it can present with several complications. Perforation due to foreign body ingestion is rare but can have severe consequences if late diagnosis occurs. A 13‐year‐old male, initially suspected of acute appendicitis, was eventually diagnosed with perforation of MD by a wood splinter‐like foreign body after intraoperative assessment. Histological analysis revealed ectopic colonic tissue within the MD, a finding whose implications are not well understood, in contrast with the well‐established complications associated with ectopic gastric and pancreatic tissues. This case highlights the diagnostic challenges of MD, which can mimic acute appendicitis, emphasizing the need for high suspicion when faced with atypical clinical presentation such as foreign body‐induced perforation. Although surgical resection of asymptomatic MD remains controversial, we recommend a case‐specific approach based on risk factors to guide decision‐making on surgical resection for asymptomatic MD. [ABSTRACT FROM AUTHOR]

Introduction: Foreign body (FB) injuries constitute an important part of admission to emergency and orthopedic clinics in daily practice. The localization and removal of FBs can be difficult. Ultrasound (USG) plays an important role in the localization of FBs. In this study, we aimed to present the results of patients who underwent US-guided FB extraction. Methods: Fifty-seven patients who were admitted to the emergency service and orthopedic outpatient clinic due to FB trauma to soft tissue were retrospectively evaluated. USG-guided removal was performed under local anesthesia. The number, size, shape, structure, distance to the skin, and integrity of the FB were determined using USG guidance. Patient satisfaction was evaluated with Roles-Maudsley score. Results: The mean duration of surgery was 7 min (range; 5 to 20 minutes), and the mean incision size was 11 mm (range; 5 to 25 mm). Forty-seven of the patients underwent an outpatient procedure and were discharged on the same day. No postoperative complications were observed. Fifty one of 57 (89.5%) were very satisfied with the surgery. Conclusion: Consequently, USG-guided FB extraction is a safe, fast, and comfortable option for the patient and the physician. Orthopedic physicians should receive USG training starting from their assistantship, and its use in daily practice should be increased. [ABSTRACT FROM AUTHOR]

Foreign bodies in soft tissue after trauma are common, and the smaller the wound, the easier it is to miss them. Moreover, undetected foreign bodies can lead to severe complications. A 60-year-old male patient presented to our emergency room with a 4-cm back laceration and a slightly decreased sensation in the left S1 dermatome after falling over a glass fish tank. A foreign body on the left side of the L5/S1 epidural space and S1 nerve root compression in the lateral recess were observed. Consequently, a midline longitudinal incision was made at the L5/S1 level, a paravertebral muscle subperiosteal dissection was performed, and the foreign body was carefully removed. Foreign bodies may exist even in simple, small wounds. Therefore, their presence should be confirmed or excluded through appropriate imaging and history-taking. [ABSTRACT FROM AUTHOR]

Retrograde movement of gastric contents into the pharynx is termed Laryngopharyngeal Reflux (LPR). It represents an extraesophageal manifestation associated with gastroesophageal reflux disease (GERD). The objective of the study is to investigate the clinical profile of LPR and its response to treatment. Three hundred consecutive patients who presented to the ENT outpatient department with a clinical profile of LPR were selected. The patients' symptoms were assessed using the Reflux Symptom Index (RSI), followed by an endoscopic examination of the larynx and scoring using the Reflux Finding Score (RFS). Patients were started on LPR treatment if they had an RSI score of 13 and an RFS of more than 7. The patients were then started on medication and monitored for three months. The most common symptom in our research sample (52%) was a foreign body sensation in the throat. On endoscopic examination of the larynx, the most common sign was hyperemia/erythema of laryngeal tissue, especially bilateral arytenoids. Most of our patients responded favorably to a combination of pantoprazole (40 mg) and domperidone (30 mg) for 4 weeks. This was measured by the reduction in RSI and RFS scores. LPR is a frequently encountered clinical entity, and otorhinolaryngologists should consider it when treating patients with chronic symptoms such as throat pain and voice changes. Appropriate LPR diagnosis and care can help prevent unnecessary prescriptions for antibiotics and surgical interventions in these patients. [ABSTRACT FROM AUTHOR]

Ingested fish bone is a common otorhinolaryngology emergency in Malaysia. Fish bone is commonly impacted in the oropharynx for young patients and oesophagus for elderly patients. Rarely, a fish bone migrated extraluminal and require surgical exploration. We report a five cases of fish bone which involved extraluminal migration, and needed repeat CT scans and various types of surgical exploration. [ABSTRACT FROM AUTHOR]

Devices for the gastrointestinal tract are widely available and constantly advancing with less invasive techniques. They play a crucial role in diagnostic and therapeutic interventions and are commonly placed by interventional radiologists, gastroenterologists, and surgeons. These devices frequently appear in imaging studies, which verify their proper placement, identify any complications, or may be incidentally detected. Radiologists must be able to identify these devices at imaging and understand their intended purpose to assess their efficacy, detect complications such as incorrect positioning, and avoid misinterpreting them as abnormalities. Furthermore, many patients with these devices may require MRI, making assessing compatibility essential for safe patient care. This review seeks to provide a succinct and practical handbook for radiologists regarding both common and uncommon gastrointestinal devices. In addition to textual descriptions of clinical indications, imaging findings, complications, and MRI compatibility, the review incorporates a summary table as a quick reference point for key information and illustrative images for each device. [ABSTRACT FROM AUTHOR]

Intraorbital foreign bodies (IOrFBs) are a significant cause of ocular morbidity. Although plastic IOrFBs are rare, the increasing use of plastic and polymer composites in motor vehicles will increase their prevalence. Although challenging to identify, plastic IOrFBs have unique radiographic characteristics. The authors describe a case of an 18-year-old man with a history of a motor vehicle accident and a left upper eyelid laceration. In retrospect, imaging suggested a plastic IOrFB, which was initially overlooked. A follow-up examination demonstrated persistent left upper lid ptosis with an underlying mass. Further work-up revealed a retained IOrFB, which was removed via anterior orbitotomy. Scanning electron microscopy of the material was consistent with a plastic polymer. This case demonstrates the importance of maintaining a high suspicion for IOrFBs in the correct clinical context, the need for increased awareness of plastic and polymer composite IOrFBs, and the use of diagnostic imaging for identification. [ABSTRACT FROM AUTHOR]

A 75-year-old immunocompetent male presented with a right orbital cellulitis after a foreign body penetrating injury. He was taken for orbitotomy with foreign body removal and started on broad-spectrum antibiotics. Intra-operative cultures were positive for Cladophialophora bantiana, a mold known for causing brain abscesses with no prior reports of orbital invasion in the literature. Following culture results, the patient was managed with voriconazole and required multiple orbitotomies and washouts for infection control. [ABSTRACT FROM AUTHOR]

The Canadian Association of Radiologists (CAR) Gastrointestinal Expert Panel consists of radiologists, a gastroenterologist, a general surgeon, a family physician, a patient advisor, and an epidemiologist/guideline methodologist. After developing a list of 20 clinical/diagnostic scenarios, a systematic rapid scoping review was undertaken to identify systematically produced referral guidelines that provide recommendations for one or more of these clinical/diagnostic scenarios. Recommendations from 58 guidelines and contextualization criteria in the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) for guidelines framework were used to develop 85 recommendation statements specific to the adult population across the 20 scenarios. This guideline presents the methods of development and the referral recommendations for dysphagia/dyspepsia, acute nonlocalized abdominal pain, chronic abdominal pain, inflammatory bowel disease, acute gastrointestinal bleeding, chronic gastrointestinal bleeding/anemia, abnormal liver biopsy, pancreatitis, anorectal diseases, diarrhea, fecal incontinence, and foreign body ingestion. [ABSTRACT FROM AUTHOR]

Purpose: There is currently no ideal radiotracer for imaging bacterial infections. Radiolabelled d-amino acids are promising candidates because they are actively incorporated into the peptidoglycan of the bacterial cell wall, a structural feature which is absent in human cells. This work describes fluorine-18 labelled analogues of d-tyrosine and d-methionine, O-(2-[18F]fluoroethyl)-d-tyrosine (d-[18F]FET) and S-(3-[18F]fluoropropyl)-d-homocysteine (d-[18F]FPHCys), and their pilot evaluation studies as potential radiotracers for imaging bacterial infection. Procedures: d-[18F]FET and d-[18F]FPHCys were prepared in classical fluorination-deprotection reactions, and their uptake in Staphylococcus aureus and Pseudomonas aeruginosa was evaluated over 2 h. Heat killed bacteria were used as controls. A clinically-relevant foreign body model of S. aureus infection was established in Balb/c mice, as well as a sterile foreign body to mimic inflammation. The ex vivo biodistribution of d-[18F]FPHCys in the infected and inflamed mice was evaluated after 1 h, by dissection and gamma counting. The uptake was compared to that of [18F]FDG. Results: In vitro uptake of both d-[18F]FET and d-[18F]FPHCys was specific to live bacteria. Uptake was higher in S. aureus than in P. aeruginosa for both radiotracers, and of the two, higher for d-[18F]FPHCys than d-[18F]FET. Blocking experiments with non-radioactive d-[19F]FPHCys confirmed specificity of uptake. In vivo, d-[18F]FPHCys had greater accumulation in S. aureus infection compared with sterile inflammation, which was statistically significant. As anticipated, [18F]FDG showed no significant difference in uptake between infection and inflammation. Conclusions: d-[18F]FPHCys uptake was higher in infected tissues than inflammation, and represents a fluorine-18 labelled d-AA with potential to detect a S. aureus reference strain (Xen29) in vivo. Additional studies are needed to evaluate uptake of this radiotracer in clinical isolates. [ABSTRACT FROM AUTHOR]

As English forces struggled to bring Ireland under Crown control during the early modern period, all aspects of Irish culture and identity were seen as potentially subversive. Irish culture posed a threat to both the regime, and to the very identity and sanctity of English bodies in a foreign and hostile land. This paper will examine the role that food played in the political discourse of sixteenth and seventeenth-century Ireland. It will investigate how aspects of food, from infant feeding, to diet, dairying and cookery became a cause of concern for English colonial commentators. It will show how descriptions of foodways were used to cast the Irish as "savages," but importantly, how they were also used to illustrate the "degeneration" of the Old English. Through the discussion of food commentators warned newcomers not to follow the fate of their predecessors; their bodies were not impenetrable, and through culinary contact, they too could be "undone." [ABSTRACT FROM AUTHOR]

Composite fan blades made of CFRP have been developed and investigated to reduce the weight of aircraft engines. Aircraft fan blades are subjected to high-speed impact by foreign objects, such as bird strikes. Because CFRP has lower impact resistance than metal materials, it is necessary to focus on possible failure not only at the impact point but also at the tip and trailing edge of the fan blade. This paper developed a finite element analysis model of fan blade geometry and investigated the dynamic deformation that may induce peripheral fracture when a bird strike occurs on a composite fan blade. Natural vibration analysis and transient response analysis were performed to analyze the vibration behavior at the fan blade periphery. The natural vibration analysis showed that the vibration modes in the out-of-plane direction of the blade are of low order. In the transient response analysis, when a group of particles defined by the equation of state and the SPH method collided, a sudden deformation in the periphery, called a whipping motion, was observed immediately after the impact. The spanwise strain has a peak value at the trailing edge of the fan blade, while the chordwise strain has a peak value at the leading edge of the fan blade. Furthermore, the transient response analysis with the fan blades rotating showed an increase in the peak strain value. A comparison of the impact loads and displacements immediately below the impact indicated that the centrifugal force increased the geometric stiffness, which increased the reaction force due to the fan blade, increasing the peak value. [ABSTRACT FROM AUTHOR]

Upon implantation into a patient, any biomaterial induces a cascade of immune responses that influences the outcome of that device. This cascade depends upon several factors, including the composition of the material itself and the location in which the material is implanted. There is still significant uncertainty around the role of different tissue microenvironments in the immune response to biomaterials and how that may alter downstream scaffold remodeling and integration. In this study, we present a study evaluating the immune response to decellularized extracellular matrix materials within the intraperitoneal cavity, the subcutaneous space, and in a traumatic skeletal muscle injury microenvironment. All different locations induced robust cellular recruitment, specifically of macrophages and eosinophils. The latter was most prominent in the subcutaneous space. Intraperitoneal implants uniquely recruited B cells that may alter downstream reactivity as adaptive immunity has been strongly implicated in the outcome of scaffold remodeling. These data suggest that the location of tissue implants should be taken together with the composition of the material itself when designing devices for downline therapeutics. Different tissue locations have unique immune microenvironments, which can influence the immune response to biomaterial implants. By considering the specific immune profiles of the target tissue, researchers can develop implant materials that promote better integration, reduce complications, and improve the overall outcome of the implantation process. [Display omitted] [ABSTRACT FROM AUTHOR]

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Key Points Penetrating orbital trauma from marine creatures, especially needlefish, should be considered after injuries sustained in open water. Advances in endoscopic sinus surgery have enabled surgeons to remove certain orbital foreign bodies through endoscopic endonasal approaches. 3D segmentation is a valuable pre‐operative tool in complex endoscopic orbital cases. [ABSTRACT FROM AUTHOR]

When a mass occurs at the staple line following lung resection, it can be difficult to distinguish between local cancer recurrence and granuloma. We present a case of a staple‐line granuloma with 18F‐fluorodeoxyglucose‐positron emission tomography uptake and elevated serum carbohydrate antigen 19–9 (CA19‐9) in a patient with ovarian cancer lung metastasis. After granuloma resection, serum CA19‐9 levels normalized, and CA19‐9 positive cells were identified in the resected tumor. Therefore, serum CA19‐9 elevation does not rule out a staple‐line granuloma. Whereas granulomas on computed tomography (CT) scans tend to show smooth shadows along the staple line unilaterally, detailed CT evaluation may help diagnostic differentiation. Differentiation based on imaging and tumor markers has limitations. However, core needle biopsy has the risk of misdiagnosis and tumor cell dissemination, therefore surgical resection should be considered when comprehensive findings indicate a potential recurrence. [ABSTRACT FROM AUTHOR]

During the foreign body response (FBR), macrophages fuse to form foreign body giant cells (FBGCs). Modulation of FBGC formation can prevent biomaterial degradation and loss of therapeutic efficacy. However, the microenvironmental cues that dictate FBGC formation are poorly understood with conflicting reports. Here, we identifiedmolecular and cellular factors involved indriving FBGCformation in vitro. Macrophages demonstrated distinct fusion competencies dependent on monocyte differentiation. The transition from a proinflammatory to a reparative microenvironment, characterised by specific cytokine and growth factor programmes, accompanied FBGC formation. Toll-like receptor signalling licensed the formation of FBGCs containing more than 10 nuclei but was not essential for cell-cell fusion to occur. Moreover, the fibroblast-macrophage crosstalk influenced FBGC development, with the fibroblast secretome inducingmacrophages to secrete more PDGF, which enhanced large FBGC formation. These findings advance our understanding as to how a specific and timely combination of cellular and microenvironmental factors is required for an effective FBR, with monocyte differentiation and fibroblasts being key players. [ABSTRACT FROM AUTHOR]

Introduction: The secure operation of electric power transmission lines is essential for the economy and society. However, external factors such as plastic film and kites can cause damage to the lines, potentially leading to power outages. Traditional detection methods are inefficient, and the accuracy of automated systems is limited in complex background environments. Methods: This paper introduces a Weighted Spatial Attention (WSA) network model to address the low accuracy in identifying extraneous materials within electrical transmission infrastructure due to background texture occlusion. Initially, in the model preprocessing stage, color space conversion, image enhancement, and improved Large Selective Kernel Network (LSKNet) technology are utilized to enhance the model's proficiency in detecting foreign objects in intricate surroundings. Subsequently, in the feature extraction stage, the model adopts the dynamic sparse BiLevel Spatial Attention Module (BSAM) structure proposed in this paper to accurately capture and identify the characteristic information of foreign objects in power lines. In the feature pyramid stage, by replacing the feature pyramid network structure and allocating reasonable weights to the Bidirectional Feature Pyramid Network (BiFPN), the feature fusion results are optimized, ensuring that the semantic information of foreign objects in the power line output by the network is effectively identified and processed. Results: The experimental outcomes reveal that the test recognition accuracy of the proposed WSA model on the PL (power line) dataset has improved by three percentage points compared to that of the YOLOv8 model, reaching 97.6%. This enhancement demonstrates the WSA model's superior capability in detecting foreign objects on power lines, even in complex environmental backgrounds. Discussion: The integration of advanced image preprocessing techniques, the dynamic sparse BSAM structure, and the BiFPN has proven effective in improving detection accuracy and has the potential to transform the approach to monitoring and maintaining power transmission infrastructure. [ABSTRACT FROM AUTHOR]

Background: This case mainly describes a relatively rare case of an old mineral-like corneal foreign body that existed for up to 20 years, and did not significantly affect the visual quality of the patient. Case presentation: A 56-year-old male miner complained of right eye vision loss for 3 years, swollen and painful for 4 months. Admission examination: Best corrected visual acuity was no light perception in the right eye and 20/20 in the left eye. Anterior segment examination: A large number of spot-like grayish-brown mineral foreign bodies in the conjunctiva of the nasal conjunctiva, emulsified silicone oil floating in the anterior chamber, Corneal foreign bodies in the right eye were widely distributed in the upper cortex and the proelastic layer. There were fewer foreign bodies in the left cornea. Previous medical history, 20 years ago due to forging and burning sulphur mine explosion, resulting in a large number of ore foreign bodies in the conjunctiva of both eyes. As these corneal foreign bodies did not affect the visual quality of the patient, we adopted a conservative treatment plan, did not remove these foreign bodies, and only carried out symptomatic treatment for the patient's secondary ocular hypertension. The patient was followed up normally in the outpatient department, and no cornea-related complications occurred up to now. Conclusions: First of all, it is necessary to understand the source and nature of the foreign body in patients with corneal and conjunctival foreign body injuries. In the second, for the old corneal metal foreign body, when the patient's visual acuity is stable and there are no symptoms of corneal irritation and inflammatory reaction, it can be Conservative treatment or outpatient follow-up observation. In the end, corneal Optical coherence tomography imaging should not be ignored, which is very important for determining the depth of embedding and the location of the corneal foreign body. [ABSTRACT FROM AUTHOR]

Self-inflicted penetrating injuries in patients with mental disorders are a rare phenomenon. The authors report the case of a prisoner who recurrently presented to the emergency department over a period of four years for self-insertion of six metal foreign bodies into the skull. Computed tomography each time revealed the presence of a metal foreign body (screw, nail, metal rod, and wire) passing through the frontal bone into the frontal lobe. In each situation, the foreign body was safely extracted with a favorable outcome. Despite the use of the latest imaging modalities, metal artifacts can limit the assessment of vascular involvement, and special attention must be given to preoperative planning. Surgical extraction of the foreign body can be safely performed when appropriate preoperative planning is carried out to consider all possible complications. [ABSTRACT FROM AUTHOR]

Addressing the limitations of current railway track foreign object detection techniques, which suffer from inadequate real-time performance and diminished accuracy in detecting small objects, this paper introduces an innovative vision-based perception methodology harnessing the power of deep learning. Central to this approach is the construction of a railway boundary model utilizing a sophisticated track detection method, along with an enhanced UNet semantic segmentation network to achieve autonomous segmentation of diverse track categories. By employing equal interval division and row-by-row traversal, critical track feature points are precisely extracted, and the track linear equation is derived through the least squares method, thus establishing an accurate railway boundary model. We optimized the YOLOv5s detection model in four aspects: incorporating the SE attention mechanism into the Neck network layer to enhance the model's feature extraction capabilities, adding a prediction layer to improve the detection performance for small objects, proposing a linear size scaling method to obtain suitable anchor boxes, and utilizing Inner-IoU to refine the boundary regression loss function, thereby increasing the positioning accuracy of the bounding boxes. We conducted a detection accuracy validation for railway track foreign object intrusion using a self-constructed image dataset. The results indicate that the proposed semantic segmentation model achieved an MIoU of 91.8%, representing a 3.9% improvement over the previous model, effectively segmenting railway tracks. Additionally, the optimized detection model could effectively detect foreign object intrusions on the tracks, reducing missed and false alarms and achieving a 7.4% increase in the mean average precision (IoU = 0.5) compared to the original YOLOv5s model. The model exhibits strong generalization capabilities in scenarios involving small objects. This proposed approach represents an effective exploration of deep learning techniques for railway track foreign object intrusion detection, suitable for use in complex environments to ensure the operational safety of rail lines. [ABSTRACT FROM AUTHOR]

Objective: Describe presenting signs, diagnostic findings, and magnet‐assisted endoscopic removal method of ferromagnetic gastric foreign bodies (FBs) in dogs. Clinical Presentation: Four dogs presented with ingestion of sharp metallic FBs. The presence of gastric FBs was confirmed by abdominal radiography. Results: In 3 cases, initial attempts at endoscopic removal were unsuccessful because of ingesta and fluid in the stomach. A magnet contained within a Roth net was introduced endoscopically. Magnet and attached objects were successfully removed from the stomach. In the fourth case, removal with a magnet was judged to be the most expedient method of removal because multiple metallic objects were present. Clinical Relevance: An endoscopic technique was used for the removal of difficult‐to‐visualize or multiple metallic FBs. The use of this technique allows the removal of ferromagnetic gastric FBs without surgery or risk of complications associated with the passage of sharp material through the gastrointestinal (GI) tract. [ABSTRACT FROM AUTHOR]

Simple Summary: When a medical implant or electrode is placed, the body often evokes an immune response in an attempt to remove it. As it fails to do so, this inflammatory response leads to a chronic fibrosis, wherein the material is walled off from the body with scar tissue. This phenomenon is known as foreign body response (FBR) and poses a significant burden, as it often impacts the implant's function and longevity. Single-cell RNA sequencing (scRNA-seq), a technique evaluating the genes transcribed at a single-cell level within a given sample, has been used to identify targets to reduce the extent of fibrosis caused by FBR. We performed a meta-analysis collecting all available FBR mouse scRNA-seq studies to identify gene signatures specific to FBR across different models and anatomic locations. Through our integrated analysis, we identified specific groups of fibroblasts and macrophages associated with FBR, characterizing their associated genes and signaling pathways. Fibroblasts enriched in FBR had increased pro-fibrotic signatures, while macrophages enriched in FBR had both increased pro-fibrotic and pro-inflammatory profiles. Collectively, our meta-analysis identifies common cell-specific gene signatures in FBR and provides potential therapeutic targets for patients requiring long-term implanted biomedical devices. Foreign body response (FBR) is a universal reaction to implanted biomaterial that can affect the function and longevity of the implant. A few studies have attempted to identify targets for treating FBR through the use of single-cell RNA sequencing (scRNA-seq), though the generalizability of these findings from an individual study may be limited. In our study, we perform a meta-analysis of scRNA-seq data from all available FBR mouse studies and integrate these data to identify gene signatures specific to FBR across different models and anatomic locations. We identify subclusters of fibroblasts and macrophages that emerge in response to foreign bodies and characterize their signaling pathways, gene ontology terms, and downstream mediators. The fibroblast subpopulations enriched in the setting of FBR demonstrated significant signaling interactions in the transforming growth factor-beta (TGF-β) signaling pathway, with known pro-fibrotic mediators identified as top expressed genes in these FBR-derived fibroblasts. In contrast, FBR-enriched macrophage subclusters highly expressed pro-fibrotic and pro-inflammatory mediators downstream of tumor necrosis factor (TNF) signaling. Cell–cell interactions were additionally interrogated using CellChat, with identification of key signaling interactions enriched between fibroblasts and macrophages in FBR. By combining multiple FBR datasets, our meta-analysis study identifies common cell-specific gene signatures enriched in foreign body reactions, providing potential therapeutic targets for patients requiring medical implants across a myriad of devices and indications. [ABSTRACT FROM AUTHOR]

Ingestion of foreign bodies is a rare clinical problem in healthy adults. Less than 1% of cases need surgery due to perforation or obstruction. Here, we describe an unusual case of a wine-cork ingestion by a 54-year-old woman with a history of chronic alcohol consumption. Computed tomography (CT) of the abdomen and pelvis revealed foreign body (FB) in terminal ileum. The proximal part of the ileum was dilated due to obstruction. Laparotomy was performed, and the FB was removed without complications. Most ingested FBs spontaneously pass through the gastrointestinal tract. However, in rare instances, the FB can cause obstruction. In case of suspicion of serious complications such as obstruction and perforation, abdominopelvic CT should be used. The application of radiographic techniques in the identification of FBs and the assessment of potential complications plays a crucial role in expediting medical interventions for patients. [ABSTRACT FROM AUTHOR]

Purpose: To determine and report the underlying cause of local inflammation causing recurrent neuropathy and multiple operations in a patient with a Barricaid® device. Methods: After removal of this patient's Barricaid® device, we sent local inflammatory tissue to pathology for histochemical analysis. Upon discovery of giant cells formation with polarizable foreign bodies, we performed a literature review regarding the Barricaid® device and its elements. Results: After two previous operations and three trials of conservative management, the presented patient underwent an L5/S1 TLIF with removal of her previously installed Barricaid® device. There were no signs of device instability/failure nor were there obvious signs of infection. Inflamed tissue proximal to the Barricaid® device was discovered, debrided, and sample sent to pathology. Removal of the Barricaid® device led to subsequent and durable relief of her symptoms. During review of this case, we discovered the polyethylene terephthalate (PET) weave used in the Barricaid® device is known to induce foreign body reactions, and this precise finding was seen in the majority of animal data submitted to the FDA for the device's acceptance. Conclusion: Given the constellation of this patient's symptoms, imaging, intraoperative, and pathology findings, previously published reports, and pre-approval data submitted to the FDA, we conclude that the inflammatory response to the PET weave in this patient's Barricaid® device was the ultimate cause of her continued neuropathy despite multiple prior surgical interventions. [ABSTRACT FROM AUTHOR]

Tissue regeneration and remodeling involve many complex stages. Macrophages are critical in maintaining micro-environmental homeostasis by regulating inflammation and orchestrating wound healing. They display high plasticity in response to various stimuli, showing a spectrum of functional phenotypes that vary from M1 (pro-inflammatory) to M2 (anti-inflammatory) macrophages. While transient inflammation is an essential trigger for tissue healing following an injury, sustained inflammation (e.g., in foreign body response to implants, diabetes or inflammatory diseases) can hinder tissue healing and cause tissue damage. Modulating macrophage polarization has emerged as an effective strategy for enhancing immune-mediated tissue regeneration and promoting better integration of implantable materials in the host. This article provides an overview of macrophages' functional properties followed by discussing different strategies for modulating macrophage polarization. Advances in the use of synthetic and natural biomaterials to fabricate immune-modulatory materials are highlighted. This reveals that the development and clinical application of more effective immunomodulatory systems targeting macrophage polarization under pathological conditions will be driven by a detailed understanding of the factors that regulate macrophage polarization and biological function in order to optimize existing methods and generate novel strategies to control cell phenotype. [ABSTRACT FROM AUTHOR]

Introduction The presence of foreign bodies in the airways remain a diagnostic challenge to healthcare professionals. They can become life threatening emergencies that require immediate intervention or go unnoticed for weeks and even months. Prevention is best but early recognition remains a critical factor in treatment of foreign body inhalation in children. Objective To study the diagnostic advantages of virtual over rigid bronchoscopy in the evaluation of children with suspected foreign body in the tracheobronchial tree and plan for early management. Methods A crossectional study conducted at a tertiary care hospital & medical college in India. A total 24 patients (0-12-years-old) who presented with complaints of sudden onset of coughing, choking, and breathing difficulty were included during the 2-year duration, from January 2018 to December 2019. All patients underwent virtual and rigid bronchoscopy. Results In 8 patients, foreign bodies detected by virtual bronchoscopy were confirmed by rigid bronchoscopy. There was one case in which virtual bronchoscopy showed no foreign body, but rigid bronchoscopy detected it. In 15 cases virtual and rigid bronchoscopy did not show foreign bodies. The sensitivity, specificity, positive and negative predictive value of virtual bronchoscopy were 88.88, 100, 100, and 93.75%, respectively. Conclusions Virtual bronchoscopy is less invasive and does not require general anesthesia but cost and availability are limitations. It can be used as method of investigation in children with suspected foreign body aspiration. [ABSTRACT FROM AUTHOR]

Introduction Submandibular gland fistula (SGF) is a rare subset of salivary gland fistulas. It is seldom tough to diagnose them prior to surgical exploration, and it is often clinically confused with close differentials. An early diagnosis based on pertinent clinical features and focused radiological findings can be pivotal in optimal management and help prevent recurrence and avoid unnecessary investigations/interventions. Objective To review articles that discuss SGF and provide vital etiological, clinical, and imaging features of this rare entity that can aid in early clinical diagnosis. Data Synthesis An extensive review involving PubMed and Google Scholar and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards. Conclusion Submandibular gland fistula is a rare entity. It can be confused with close differentials, including branchial fistulas, if not thoroughly examined. Discharge from fistulae along with submandibular pain/tenderness and/or swelling are important diagnostic clues. A history of trauma, nodule at the site of discharge, prior submandibular disease/calculi, or discharge aggravated with food further increases a clinical suspicion. Optimal radiological investigation looking for calculi/foreign body and delineating the fistula tract is vital to affirm a diagnosis. Gland with fistula excision is a commonly advocated treatment of choice with no reports of recurrence, although conservative management and gland preserving surgery have also reported a favorable prognosis. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To provide veterinarians with updated radiographic descriptions of select radiolucent foreign material in a simulated gastrointestinal environment. SAMPLE: 368 veterinarian respondents from the US. METHODS: An online survey was administered between June 18, 2023, and July 2, 2023, through a private veterinarian-based social media group. Representative commonly ingested foreign bodies were radiographed surrounded by air and water to simulate being within the gastrointestinal tract. Two examiners evaluated and qualified the opacity of the objects for each environment. RESULTS: The private social media group had a total of 3,900 members including veterinarians from all disciplines. A total of 362 small animal veterinarians (9.3% of the group) responded to the study reporting a total of 123 foreign objects that were not causing mechanical obstruction at the time of initial presentation. Sixty-eight foreign bodies were reported greater than or equal to 5 times and grouped as balls (n = 4), food (9), fabric (14), wood (3), soft plastic (14), hard plastic (18), or other (6). Most (98.5% [67/68]) objects were easily identifiable in air. In water, 23.5% (16/68) of the objects were obscured, and 39.7% (27/68) had inversion of the major opacity when compared to the opacity in air. CLINICAL RELEVANCE: The opacity of some ingested radiolucent material can invert relative to air or fluid, which may reflect substantial differences in detection following repositioning. When known dietary indiscretion occurs, radiographing a sample of the material in air and water will improve the accuracy of assessment. [ABSTRACT FROM AUTHOR]

The early diagnosis and treatment of foreign body aspiration (FBA) can significantly improve the overall prognosis of children. There are significant differences in the epidemiology and clinical characteristics of FBA in different regions. Therefore, we conducted a real-world study in the western region of China with over 4000 patients. The aim of this study was to improve the understanding of FBA in terms of its types, the specific months of its occurrence, and the distribution of primary caregiver characteristics in western China. We collected the clinical and epidemiological data of children who were diagnosed with FBA in our hospital over the past 20 years through a big data centre. We matched the data of healthy children who underwent routine physical examinations at the paediatric health clinic during the same period to analyse the differences in the data of actual guardians. A total of 4227 patients from five provinces were included in this study. Foreign bodies were removed by rigid bronchoscopy in 99.4% (4202/4227) of patients, with a median age of 19 months and a median surgical duration 16 min. January was the most common month of onset for 1725 patients, followed by February, with 1027 patients. The most common types of foreign objects were melon peanuts, seeds and walnuts, accounting for 47.2%, 15.3%, and 10.2%, respectively. In the FBA group, the proportion of grandparents who were primary caregivers was 70.33% (2973/4227), which was significantly greater than the 63.05% in the healthy group (2665/4227) (P < 0.01). FBA most commonly occurs in January and February. More than 60% of FBAs occur between the ages of 1 and 2 years, and the incidence of FBA may be greater in children who are cared for by grandparents. A rigid bronchoscope can be used to remove most aspirated foreign bodies in a median of 16 min. [ABSTRACT FROM AUTHOR]

Background: Upper gastrointestinal foreign body ingestion is a common digestive tract emergency, of which completely embedded ones were challenging for most endoscopists. We aim to evaluate the efficacy and safety of endoscopic submucosal fenestration in the treatment of completely embedded upper gastrointestinal foreign bodies. Methods: From December 2018 to December 2021, 19 patients with completely embedded upper gastrointestinal foreign bodies who underwent endoscopic submucosal fenestration in Zhongshan Hospital, Fudan University were included. The safety, efficacy, and outcome were retrospectively reviewed. Results: Among the 19 patients, 15 foreign bodies were embedded in the esophagus, 3 located in the gastric wall, and 1 located in the duodenal bulb. The foreign bodies were successfully managed in 12 cases, and 7 failed after attempts of repeated exploration. Two cases confirmed completely traversing into the mediastinum were successfully removed after transfer to surgery. One case had retrieval of a foreign body in a half-year examination. Till now, 3 failed patients had great relief of symptoms and only one patient claimed occasional thoracodynia. Of note, there were neither serious adverse events, nor long-term complications during the follow-up. Conclusion: In disposing of foreign bodies completely embedded in the upper gastrointestinal tract, ESF is a safe and effective alternative to surgery. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this retrospective study was to explore the clinical characteristics of and diagnostic and therapeutic strategies for the removal of fish bones that migrate to the neck. Methods: We reviewed the clinical data of 30 patients over the past 12 years who underwent neck surgery in our otorhinolaryngology department for the migration of fish bones from the throat. The location of fish bones and the positivity rate of different examination methods (neck CT and B-ultrasound) were evaluated statistically. The diagnosis and treatment strategy for fish bone migration to the neck was also summarized. Results: A total of 24 patients had a history of foreign body ingestion. The duration from foreign body ingestion to the appearance of symptoms in the neck ranged from 26 to 151 days, with a median of 50 days (interquartile range, 32–86 days). Among the 24 patients with fish bones located in the front or side of the neck, 50% (12/24) and 100% (24/24) of whom had positive neck CT and B-ultrasound results, respectively. Additionally, for 6 patients with fish bones in the retropharyngeal space, the positive rate for neck CT was 100%, whereas neck B-ultrasound showed negative results due to the air and depth in the trachea and esophagus. A strong correlation was observed between the length of fish bones detected by B-ultrasound and CT and the actual length. Indeed, no significant difference was observed between the length of fish bone determined by B-ultrasound and the actual length. In patients with fish bones located in the anterior and lateral neck regions, the foreign bodies were successfully removed by a lateral cervical approach operation (23/24). For the 6 cases with fish bones located in the retropharyngeal space, all (6/6) were removed by incising the posterior pharyngeal wall with assistance from transoral endoscopy. Conclusions: The techniques of B-ultrasound and CT have advantages for the diagnosis of migratory foreign bodies in the neck. Although B-ultrasound is more accurate for estimating the length of migratory fish bones in the neck, a combination of both methods can improve the preoperative positive rate of diagnosis. Therefore, a variety of surgical approaches should be employed to manage the different locations of cervical foreign bodies. [ABSTRACT FROM AUTHOR]