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Removal of foreign bodies in the parapharyngeal space from penetrating oral trauma in infants is troublesome due to the difficulty of diagnosis. We herein report the case of a foreign body, namely the tip of a chopstick, which was removed by endoscopic surgery using the navigation system in an infant patient. A 2-year-old boy suspected of foreign body ingestion, namely the tip of a chopstick, was brought to our hospital. There were superficial lacerations to the palate and the right posterior wall of the epipharynx. Enhanced computer tomography (CT) showed a small air shadow in the right parapharyngeal space close to the cervical vertebra. We tried to remove the foreign body endoscopically under general anesthesia, but could not find it after six hours of searching. Subsequent CT revealed an increase in Hounsfield units (HU) of a small region in the parapharyngeal space 24 days after the first operation. We again tried to remove the tip endoscopically, this time using the navigation system. The tip, measuring 13mm, was removed successfully in 32 minutes without bleeding or any subsequent complications. A change of HU in CT findings tipped us off as to the location of the wooden foreign body. Endoscopic surgery using the navigation system is a useful tool to detect and remove small parapharyngeal foreign bodies in pediatric patients.

Small foreign body in the parapharyngeal space in an infant removed by endoscopic surgery using the navigation system