Electronic Gastroscopy in Identifying Hidden Tonsillar Foreign Bodies: A Case of a Completely Embedded Sunflower Seed Shell.

BACKGROUND Pharyngeal foreign bodies are common in otolaryngology and often occur as isolated events. Swallowing can cause the foreign body to shift, making detection by laryngoscopy difficult. Delayed diagnosis and treatment may result in complications such as cervical masses, floor of mouth abscesses, retropharyngeal abscesses, laryngeal granulomas, or tongue masses. Penetration of a foreign body into the tonsil can lead to recurrent unilateral tonsillitis. For foreign bodies undetectable by laryngoscopy, digestive endoscopy may provide valuable diagnostic assistance. CASE REPORT On June 1, 2024, a 38-year-old woman presented with throat pain and persistent foreign body sensation after consuming sunflower seeds. She underwent 2 otolaryngologic examinations, but no foreign body was detected by laryngoscopy, and her symptoms persisted. On June 3, she underwent gastroscopy under intravenous general anesthesia. A yellow dot was observed on the right palatal tonsil, suggesting a completely embedded foreign body. Using foreign body forceps, a 4-mm wooden fibrous fragment was extracted. The patient experienced immediate relief; her throat pain and foreign body sensation completely resolved after removal. CONCLUSIONS When a foreign body cannot be identified by laryngoscopy, it may have completely penetrated the tonsil. In such cases, electronic gastroscopy can serve as a valuable adjunct in the diagnosis and management of pharyngeal foreign bodies.