An 8-year 11-month-old girl was examined in the Emergency Department of Mayo Clinic, Rochester, Minn, after five hours of intermittent choking, coughing, and acute aphonia. These symptoms occurred suddenly while the girl was grooming her "Barbie" doll. She was rushed to the local hospital's emergency department. The girl was aphonic and drooling, but indirect laryngoscopy yielded apparently normal findings. Vital signs and respirations were stable. She was treated with oxygen by mask and transferred by ambulance to the clinic.
Coughing and/or choking had stopped, but she continued to drool. She was alert, with good color, and afebrile, with vital signs and respirations remaining stable. Her face and neck showed no signs of injury or disease. Occasional inspiratory stridor was exacerbated by lying supine. Rhonchi were auscultated over the lower portion of the left lung. She had not been taking any medications. There were no known allergies, but a few weeks