Endoscopic Management of Crayfish (Procambarus clarkii) Aspiration: A Case Report.

INTRODUCTION

Airway foreign bodies are time-sensitive otolaryngologic emergencies that can occur in persons of any age. We describe a unique case of complete aphonia caused by the impaction of a crayfish (Procambarus clarkii) claw at the level of the vocal cords.

CASE PRESENTATION: A 65-year-old man developed abrupt throat discomfort and loss of voice while eating crayfish. Indirect laryngoscopy showed a foreign body resting across the vocal cords with absent vibration. Cervical CT demonstrated a tubular hyperdense structure within the glottic region, and flexible transoral bronchoscopy confirmed a mucus-coated object adherent to the vocal cords. The object was removed en bloc with grasping forceps under topical anesthesia, after which phonation returned immediately. The patient was discharged the next day without complications. The retrieved foreign body was identified as a crayfish claw.

CONCLUSIONS

Crayfish claw impaction at the vocal cords is an exceedingly rare cause of aphonia. Incorporating a targeted dietary history-particularly of regional or seasonal foods-can expedite the diagnosis and management of unusual airway foreign bodies.