Throat & Voice

Swallowed a fish bone? This is how it is removed by an ENT Specialist

February 3, 2020
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With Chinese New Year just around the corner and with fish being an auspicious food,  many Singaporeans will be having more fish meals in the coming weeks. However, Dr Gan, an ENT Specialist in Singapore, warned that one better be extra careful when enjoying one of the fish meals!

 

Dr Gan was recently called to see a patient, Mr A, around midnight at the Accident & Emergency (A&E) at Mount Elizabeth Novena Hospital. The patient was a 56 year old Chinese gentleman who had just accidentally swallowed a fish bone while enjoying his fish-head curry supper. He subsequently complained of piercing pain in his throat which was worse on swallowing.

 

On examination, a nasoendoscopy (scope through the nose and down to the back of the throat) showed a curvilinear fish bone embedded at the back of his left tongue (near the region of his voicebox). The endoscope has a working channel that allows Dr Gan to insert a grasping forceps. This enables the bone to be extracted safely under direct vision. The process took about a minute and his pain resolved immediately.

 

 

 

 

 

Swallowed fish bone is one of the most common ENT emergencies seen in Singapore. The most common sites for a fish bone to get stuck in the throat are the tonsils (2 oval-shaped glands at the back of your throat), back of the tongue (in areas known as base of tongue and valleculae) and the food pipe (known as esophagus).

 

While most fish bones stuck in the throat region can be removed with a pair of forceps in the clinic, those that are stuck in the food pipe are much more difficult to get to and will have to be removed under general anaesthesia (with patient asleep). Fish bone in the food pipe are removed by passing a rigid scope (A long lighted tube) down the food pipe. The visualized fish bone can then be removed with and a grasping forceps that is passed through the rigid scope. Most swallowed fish bones can be removed without any complications. However, a swallowed fish bone that has been left embedded in the throat or food pipe for a prolonged period of time has a risk of infection and migration of the fish bone into deeper structures in the neck. Migrated fish bone causing injury to one of the large blood vessel in the neck resulting severe bleeding and death has happened before in Singapore. Hence, fish bones stuck in the throat or food pipe are serious conditions that warrants urgent intervention!

 

The first thing that you should do if you choked on a fish bone is to head to the nearest GP clinic, ENT clinic or A&E in the hospital. It should be removed by a trained doctor who has the necessary equipment to remove the bone. Trying to dig out the bone with your fingers or to flush it down with rice are not recommended as these action can lead to more injuries, migration of the fish bone or penetration of the fish bone deeper into the neck. Contrary to popular believe, drinking vinegar will not dissolve the bone.

 

 

To prevent accidental choking of or swallowing a fish bone, one should :

 

  • Avoid swallowing fish with bones together with rice in one spoonful. Eat them separately.
  • Avoid talking or laughing when eating fish meat with bones
  • Avoid rushing when eating fish with bones
  • Remove all visible fish bones on the plate rather than putting a big piece of fish in your mouth to feel and “dissect” the bones out.

When Should You See An ENT Specialist In Singapore?

  • Any Ear, Nose or Throat symptoms that you are troubled with or concerned of
  • Persistent blocked nose with mouth breathing or snoring

Dr Gan Eng Cern

Dr Gan Eng Cern is a fellowship trained Consultant Ear, Nose & Throat (ENT) Surgeon. He completed his ENT training in Singapore and obtained his subspecialty training in Rhinology and Endoscopic Skull Base Surgery at the world renowned St Paul’s Sinus Centre, University of British Columbia, Vancouver, Canada. He was also a Senior Clinical Lecturer at Yong Loo Lin School of Medicine at the National University of Singapore. Dr Gan was an avid researcher with numerous publications in reputable international ENT journals. He was also an invited speaker and surgical dissection teacher in many ENT conferences and courses.

Awards

  • 2020 – Reader’s Choice Gold Award for Best ENT Specialist
    (Expat Living Singapore)
  • 2016 – Best Educator Award (Eastern Health Alliance)
  • 2016 – “Wow” Award (Patient Compliment)
  • 2014 – Eastern Health Alliance Caring Award – Silver
  • 2014 – 19th Yahya Cohen Memorial Lectureship (awarded by the College
    of Surgeons, Academy of Medicine Singapore for best scientific surgical
    paper)
  • 2012 – Human Manpower Development Award (Ministry of Health,
    Singapore)
  • 2007 – Singhealth Best Doctor Award

Qualifications

  • MBBS - Bachelor of Science, Bachelor of Medicine, Bachelor of Surgery (University of New South Wales, Sydney, Australia)
  • MRCS (Edin) - Member of the Royal College of Surgeons Edinburgh, United Kingdom
  • MMed (ORL) - Master of Medicine in ENT (National University of Singapore)
  • FAMS - Fellow of the Academy of Medicine Singapore

Why Choose Dr Gan Eng Cern

1

Reliable & Reputable ENT Expert

Experienced and patient ENT Specialist who has your best interests at heart. We aim to provide you with accessible and specialized care for any ENT condition in a comfortable setting.

2

Friendly & Helpful Clinic Staff

Our friendly staff will assist you to the best of our ability and we are happy to accept most insurance providers and assist with E-filing with relevant insurance providers or Medisave.

3

Advanced ENT Equipment & Fully Equipped Facility

Our ENT Specialist, Dr Gan Eng Cern, will be able to diagnose and offer personalised treatments for your specific ENT condition. You can expect a high level of ENT care in a spacious setting with in-house minor surgical, endoscopy, allergy testing and microscopy services.

4

Financial Options

There are various financial options available for you to ensure that you are able to receive the most optimal treatment and care. Our ENT clinic staff will be able to assist you with your medical insurance claims and work with your chosen healthcare organization to minimize the hassle and paperwork required. In some cases, you may be able to utilise the funds in your Medisave account to defray part of the costs of your treatment. As our clinic is accredited by the Medisave board, we are able to process your claims from your Medisave for certain clinic procedures.

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