Oesophageal foreign body removal may be challenging. If a foreign body is sufficiently high risk and cannot be retrieved via oesophagoscopy, laparotomy may be required as the foreign body migrates distally.

This paper presents the use of the plastic tubing from an intravenous giving set, combined with rigid oesophagoscopy grasping forceps, in order to improve purchase and obtain sufficient traction on a large, smooth, metallic distal oesophageal foreign body (knife).

This method offers an option for removal of oesophageal foreign bodies that may be rendered challenging with traditional metal grasping forceps given the lack of purchase and traction afforded by a ‘metal on metal’ grip, potentially avoiding the need for open surgery.

Rigid oesophagoscopy is a widely used therapeutic and diagnostic procedure. Smooth friction-free insertion of the rigid scope is important to prevent oral and oesophageal mucosal damage, as such damage can cause delays in oral intake or more serious complications such as perforation. Protection appliances such as gum guards are useful adjuncts to cushion the teeth in rigid oesophagoscopy; however, there are no specific adjuncts for the edentulous patient.

In order to investigate different adjuncts, the force required to pull a standard adult rigid oesophagoscope from a metal clamp whilst enclosed in dry gauze, wet gauze, a gum guard or sleek on gauze was recorded, and a prospective audit of post-procedural trauma was performed.

Less force was required to create movement of the scope against sleek on gauze, with a lower rate of oral trauma (8 per cent) compared to that reported in the literature. Sleek on gauze is recommended for the edentulous patient.

To determine the utility of bronchoscopy to identify synchronous primaries in head and neck cancer patients.

Case series with chart review.

The charts of all patients undergoing bronchoscopy between January 2008 and December 2013 were reviewed. Only those undergoing bronchoscopy as part of panendoscopy for head and neck cancer were included. Operative reports, pathology reports and discharge summaries were reviewed for operative findings, complications and length of hospital stay.

A total of 404 charts were reviewed and 168 were included in the study. No synchronous primaries were identified. Bronchoscopy changed clinical management in one patient. There were no complications from bronchoscopy.

Bronchoscopy is a safe and well-tolerated procedure commonly performed in the investigation of head and neck cancer patients, but it adds little additional useful clinical information. Routine performance of bronchoscopy in this setting should be weighed against its added costs, and tailored to the individual patient.

This study presents the incidence of denture impaction in the oesophagus, and discusses the difficulties of managing such cases.

A total of 262 patients with a history of foreign body ingestion (between 1999 and 2010) were reviewed; 46 of these patients had dentures impacted in the oesophagus.

The cervical section of the oesophagus was the commonest site of impaction. Dysphagia and tracheal tenderness were the most consistent features when dentures became impacted in the upper oesophagus. In most cases, rigid oesophagoscopy enabled successful removal of the impacted denture. Locating an impacted denture hidden within the oesophageal mucosal folds sometimes proved difficult.

In cases of impacted dentures in the oesophagus, a positive history helps in the diagnosis, but a high degree of clinical suspicion aids early detection. Conventional radiographs are important but may not always be of assistance. Early intervention reduces complications. Dentures that are poorly maintained and old are more likely to be swallowed accidentally. The inclusion of radiopaque filler within dentures would assist localisation following accidental swallowing.