Successful Management of a Foreign Body Impacted in the Hard Palate - A Case Report From a Rural Setting

Sep 28, 2026

Uploaded by Himbo

Foreign body ingestion and impaction in children present significant diagnostic and therapeutic challenges, especially in atypical sites such as the hard palate. This case report describes successful extraction of a doll’s eye embedded in the hard palate of an 18-month-old female child in a rural setting. Using intravenous anesthesia and basic surgical facilities, the foreign body was removed safely despite limited specialized care access. The report highlights risks and the need for prevention and parental education.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages4

Reading Time10 min

AccessFree to download

Introduction

Case History/Examination

Methods

Conclusion and Results

Clinical Case Reports CASE REPORT OPEN ACCESS Successful Management of a Foreign Body Impacted in the Hard Palate: A Case Report From a Rural Setting Shishir Pokhrel1 | Sudesh Jang Thapa2 | Eliza Karki3 | Sabnam Sangraula4 | Naveen Gautam5 1Department of Otorhinolaryngology, Rapti Provincial Hospital, Tulsipur, Nepal | 2Rapti Lifecare Hospital, Tulsipur, Nepal | 3Department of Psychiatry, Tulsipur, Nepal | 4Department of Anesthesiology, Tulsipur, Nepal | 5Rapti Provincial Hospital, Tulsipur, Nepal Correspondence: Naveen Gautam ([ngautam661@gmail.com](ngautam661@gmail.com)) Received: 21 September 2024 | Revised: 13 November 2024 | Accepted: 18 September 2025 Keywords: anesthesia | foreign body impaction | hard palate | pediatric | rural setting ABSTRACT Foreign body ingestion and impaction in children pose significant challenges, particularly in atypical locations like the hard palate. This case report details the successful management of a doll's eye embedded in the hard palate of an 18-month-old female child in a rural setting, highlighting the importance of clinical acumen, resourcefulness, and prompt intervention. Despite limited specialized care access, the foreign body was safely extracted under intravenous anesthesia using basic surgical facilities. This case underscores the risks associated with foreign body impaction in young children and emphasizes the need for preventive strategies and parental education. 1 | Introduction Foreign body ingestion and impaction, which affect up to 75% of cases in children aged 6 months to 3 years, present significant diagnostic and therapeutic challenges in pediatric care [1, 2] . While the esophagus and airway are common sites, hard palate impaction is very rare [3] . Due to its anatomical constraints and potential complications, it poses unique management difficulties [4] . Delayed intervention can lead to severe outcomes, including infection, airway obstruction, or palatal perforation [4] . This case report details the successful management of a foreign body embedded in the hard palate of an 18-month-old female child in a rural setting. It highlights the critical role of clinical acumen, resourcefulness, and prompt intervention, especially where specialized care access is limited. The case emphasizes the risks associated with foreign body impaction in young children and underscores the importance of preventive strategies and parental education in reducing incidence rates. 2 | Case History/Examination An 18-month-old female child (weight: 11.2 kg, height: 82 cm) presented to the emergency department of a rural hospital with a foreign body impacted in the hard palate. The child's mother reported witnessing the incident 30 min prior, when the patient was playing with a doll and suddenly brought her hand to her mouth. On examination, vital signs were stable (heart rate: 110 bpm, respiratory rate: 24/min, temperature: 37.0°C, SpO2 : 99% on room air) . Oral inspection revealed a cylindrical plastic object, identified as a doll's eye (diameter: 5 mm), firmly embedded in the anterior hard palate, 1.5 cm posterior to the incisive papilla (Figure 1) . The surrounding mucosa showed no erythema, edema, or active hemorrhage. 3 | Methods Initial attempts at manual extraction using Magill forceps were unsuccessful. Preoperative investigations included complete blood This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. © 2026 The Author(s). Clinical Case Reports published by John Wiley & Sons Ltd. Clinical Case Reports, 2026; 14:e71778 1 of 4 [https://doi.org/10.1002/ccr3.71778](https://doi.org/10.1002/ccr3.71778) Key Clinical Message Successful management of hard palate foreign body impaction in a resource-limited setting is achievable with prompt recognition, appropriate anesthesia, and basic surgical f

FAQs

What was impacted in the child’s hard palate and where was it located?

A cylindrical plastic object identified as a doll’s eye was firmly embedded in the anterior hard palate, about 1.5 cm posterior to the incisive papilla.

Why is hard palate foreign body impaction challenging in children?

It is rare and, due to anatomical constraints, can lead to unique management difficulties and severe complications if intervention is delayed.

How was the foreign body successfully removed in this rural case?

Manual extraction with Magill forceps failed; under intravenous anesthesia with propofol and ketamine and with a Dingman mouth gag for visualization, it was extracted using curved hemostatic forceps with minimal bleeding.

Sep 28, 2026

Uploaded by Himbo