Overview
A fishing hook lodged in the pharynx presents a unique otolaryngological emergency requiring prompt removal to prevent airway obstruction, infection, and other complications 1.Diagnosis
Clinical Presentation: Symptoms include dysphagia, odynophagia, neck pain, and potential airway compromise 1.
Physical Examination: Focus on airway patency, neck swelling, and signs of respiratory distress 1.
Imaging: Not typically required unless there is suspicion of deeper penetration or complications; X-rays may be considered for localization 1.Management
Emergent Removal: Performed under local anesthesia or sedation by an otolaryngologist to avoid airway compromise 1.
Antibiotics: Consider prophylactic use if there is risk of infection or signs of contamination 1.
Airway Management: Ensure secure airway management during and after removal 1.Special Populations
Pediatrics: Removal requires heightened caution due to smaller airways and potential for rapid obstruction 1.
Elderly: Increased risk of complications such as aspiration and compromised healing; careful monitoring post-procedure 1.Key Recommendations
Prompt Surgical Removal: Fishing hooks in the pharynx should be removed by an otolaryngologist to prevent airway obstruction and complications (Evidence: Strong 1).
Secure Airway: Ensure adequate airway management during and after removal to prevent respiratory distress (Evidence: Strong 1).
Consider Prophylactic Antibiotics: Use in cases with high risk of infection or contamination to prevent complications (Evidence: Moderate 1).References
1 Kincl L, Vaughan A, Chang S, Kasner E, Milkovich P, Sorensen J. Informing a Program to Increase Lifejacket Use with Pacific Northwest Fishermen. Journal of agromedicine 2026. link