Ingested foreign body is one of the most frequently encountered emergencies in otolaryngology practice. Many of these foreign bodies get lodged in the upper digestive tract and can be removed endoscopically. Few of these foreign bodies can perforate the upper digestive tract and an even smaller number of these can migrate extraluminally. Although, a migrating foreign body can remain quiescent, they can cause life-threatening suppurative or vascular complications; hence, location and removal is essential. Here we report two cases of extraluminal migration of foreign body which was removed by neck exploration.

Spasm of the pharyngo-oesophageal segment is one of the important causes of tracheo-oesophageal voice failure. Traditionally it has been managed by either prolonged speech therapy, surgical pharyngeal myotomy or pharyngeal plexus neurectomy with varying degrees of success. Botulinum neurotoxin has been found to be effective in relieving pharyngo-oesophageal segment spasm. Since 1995, we have used botulinum toxin injection on 10 laryngectomees with either aphonia or hypertonicity due to pharyngo-oesophageal segment spasm. Early results were analysed by the Sunderland Surgical Voice Restoration Rating scale. Seven of the 10 patients, who were previously completely aphonic, developed voice following this therapy and are using their valve choice as their only method of communication. Out of the three patients who were treated for hypertonic voice, two did derive some benefit from the procedure. One patient developed a hypotonic voice, which lasted for a few months.

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