A male in his 30s presented with severe pain in his throat, voice change, and blood-tinged sputum after a hot sweet potato lodged in his throat. Thermal injury of the vocal cords!
A male in his early 30’s presented to the emergency department with a history of lodged sweet potato in his throat 8 hours prior to the presentation. The patient warmed his sweet potato in the microwave, checked the temperature by touching it before eating. Although according to the patient, it did not feel extremely hot on the touch, the sweet potato was in fact hot for the mouth!
When he bit the potato, it was hot. He tried to quickly swallow it. Unfortunately, instead of travelling down the food pipe, the sweet potato lodged in his throat causing extreme discomfort.
The patient had an 11 years old history of left-sided spastic hemiparesis after an unfortunate motor vehicle accident. Hemiparesis is a neurological damage that renders half of the body unable to move due to muscle spasm. Therefore, after the accident, he was unable to move his limbs. Besides the paralysis of the limbs, he also suffered partial-paralysis of vocal cords on one side, i.e., unilateral vocal fold paresis. Therefore, he had restricted movement of a vocal cord.
The patient had no previous history of similar events. He never had difficulty swallowing food. However, this time the ingested hot sweet potato resulted in supraglottic burns.
Although the sweet potato lodged in his throat, the patient was able to expectorate it within a few seconds. However, he noticed blood-stained sputum when the potato dislodged. Moreover, with time, his pain increased in severity and his voice quality also changed. Gradually, he started to have difficulty in breathing, therefore, he rushed to the ED to seek immediate professional help.
In the ED, the doctors started him on IV Dexamethasone (steroid) and “Kool’s solution” (mix of diphenhydramine, Lidocaine, and Maalox).
A lateral neck X-ray showed thickened epiglottis and aryepiglottic folds. An ENT specialist recommended flexible laryngoscopy which revealed moderate areas of loss/removal of normal tissue by thermal injury (burn by a hot sweet potato). Moreover, it also revealed swollen epiglottis, AE folds, and bilateral arytenoid cartilages.
For airway observation, the doctors admitted the patient and administered additional 3 doses of steroids, antibiotics, and a proton-pump inhibitor.
He recovered uneventfully so the doctors discharged him after 18 hours of observation. They prescribed him an antibiotic, i.e. Augmentin, Nystatin, PPI, and a cold liquid diet.
At 1-week follow-up, he told that his voice was getting back to normal and the pain was bare minimum. Videostroboscopy showed healing burns. However, areas of denudation and granulation along the aryepiglottic folds were still present. Additionally, the vibration of the true vocal folds was also impaired.
At 2-week follow-up, his pain had completely resolved, his voice was normal, and videostroboscopy showed an almost complete resolution.
There were no long-term complications in the subsequent visits.
Source: Pinther S, Codino J, Rubin A. Laryngeal Burn from a Sweet Potato: A Case Report. SMRJ.
2020;4(2). doi:10.51894/001c.11641
