Fish bones at the cricopharyngeus: a comparison of plain-film radiology and computed tomography

OBJECTIVES: To compare and contrast the use of plain film radiology and computed tomography (CT) scanning in the detection of fish bones at the level of the cricopharyngeus. STUDY DESIGN: Prospective study of 30 different fish bones placed at the level of the cricopharyngeus in a fresh human cadaver head and neck specimen and imaged using both plain films and CT scans. METHODS: Thirty different bones from 10 different local species of fish were selected and grouped as small, medium, or large in size. Both plain-film and CT images of the bones were reported by a radiologist as A, easily seen; B, seen on close inspection; or C, not seen. Results were analyzed using McNemar's test. RESULTS: CT scanning was superior to plain-film radiology in demonstrating the presence of fish bones at the level of the cricopharyngeus (P < .0001, McNemar's test, df = 1 when comparing report type A with B and C). CONCLUSION: The superior usefulness of CT scans in demonstrating the presence of fish bones lodged at the cricopharyngeus has been clearly shown in this study; therefore we advocated its use in selected cases.