Background: Ingestion of fishbones is a common otolaryngologic emergency, but migration or
impaction in the lower airway is rare. When the foreign body lodges in the laryngeal or bronchial
region, timely diagnosis and removal are critical to prevent airway obstruction, bleeding, or secondary
infection.
Case presentation: We report a 45-year-old Cambodian male presenting with persistent throat
discomfort and dry coughing following fish consumption. Chest X-ray was inconclusive, but the cervical
CT scan revealed a sharp fishbone embedded in the right vestibular fold and confirmed with flexible
bronchoscopy. The foreign body was successfully extracted using flexible bronchoscopy under local
anesthesia without complications. The bronchoscopy image showed an inflammation, mild bleeding
and oedema on the extraction area. The patient’s symptoms resolved immediately after the procedure.
Conclusion: This case highlights the diagnostic value and safety of flexible bronchoscopy in managing
upper airway foreign bodies, even in anatomically delicate locations like the vestibular fold. Prompt
recognition and endoscopic intervention can prevent unnecessary surgical exploration.
