Approach to a Sewing Needle in the Parapharyngeal Space: A Case Report


  • Vishaka Bettadahalli, MS (ENT), MRCSEd (ENT) Lady Hardinge Medical College; The Queen Elizabeth Hospital King’s Lynn NHS Foundation Trust
  • Rahul Bhargava, MS (ENT), DNB Lady Hardinge Medical College; SMI Saroj Medical Institute, Delhi
  • Sunil Kumar, MS (ENT), DNB Lady Hardinge Medical College


Foreign body, sewing needle, parapharyngeal space;, surgical emergency



Objective: To describe a unique situation of a sewing needle lodged in the parapharyngeal space and elucidate the problems encountered in its successful removal.


Design: Case Report

Setting: Tertiary Private Hospital

Patient: One                                               

Result: A 24-year-old male tailor accidentally swallowed a sewing needle that pierced the oropharyngeal wall and was wedged in the parapharyngeal space. After a thorough physical examination, 70 degree rod endoscopy, radiography and doppler ultrasonography and intraoperative C-arm X-ray for intraoperative localization and as a guide for extraction all yielded less than optimal guidance. Although an intra-oral approach was initially taken, the transcervical approach provided the best access.

Conclusion: Removal of a sharp foreign body in the parapharyngeal space should be considered a surgical emergency owing to its close proximity to vital structures and the potential for serious complications. Identifying the exact location may require a variety of imaging modalities, and foreign body extraction may entail multiple surgical approaches.


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How to Cite

Bettadahalli V, Bhargava R, Kumar S. Approach to a Sewing Needle in the Parapharyngeal Space: A Case Report. Philipp J Otolaryngol Head Neck Surg [Internet]. 2021 Nov. 11 [cited 2022 May 27];36(2):36. Available from: