Warning: Graphic content

A New Zealand toddler was impaled through the top of their mouth with a metal straw after falling from their push bike - but walked out of hospital the next day with no further problems.

The 21-month-old girl presented at a rural emergency department with a retractable metal straw in the roof of her mouth.

She was “intermittently distressed but consolable” and clinically stable, said three Dunedin-based specialists who treated her.

The doctors detailed the unusual case in the latest New Zealand Medical Journal. The child, date and location are not identified.

The specialists wrote that an X-ray was taken at the regional ED, which found that the straw had penetrated the girl’s nasal sinuses and was possibly sitting at the base of her skull.

A CT scan confirmed the tip of the straw was buried into the sphenoid bone, at the base of the cranium.

The girl was urgently transferred by helicopter to the nearest tertiary hospital about four and a half hours after the first 111 call was made. Her parents accompanied her, along with doctors in case she needed emergency intubation.

She was taken immediately into theatre, sedated, and the straw was removed “in one attempt without resistance” - about six hours after the accident. Doctors said they were able to close up the hole in her palate.

The young patient was discharged the following day with antibiotics and there were “no further issues”, the journal article said.

The 16cm long straw was removed by doctors after around six hours. Photo / NZMJ

The specialists, Dr Jacob Arahill-Whitham, Dr Hitesh Taylor, and Dean Ruske, said penetrating injuries to the hard palate were rare and presented risks to the orbit and brain. They only required surgery in about 1-in-10 cases.

They were usually the result of a child falling with an object in their mouth, such as toothbrushes, toys, cooking utensils, stationary and sticks.

“The case highlights complexities associated with the management of paediatric airways in rural settings and the potential dangers of rigid drinking straws for children,” the article concluded.

While such injuries were relatively rare, rigid drinking straws were likely to become more common as single-use plastic straws were phased out.

“Clinicians and parents should be made aware of the associated risks.”

Isaac Davison is a senior reporter who covers Auckland issues. He joined the Herald in 2008 and has previously covered the environment, politics, social issues, and healthcare.