Grass heads, such as the inflorescences of timothy and barley, have on occasion been aspirated into the lungs, especially by children. Fourteen new cases are here added to 51 described by previous authors. The foreign body usually descends into the right bronchus rather than the left. The inflorescence of timothy is classed as nonextrusive; it generally remains in the bronchus until removed by bronchoscopy or pulmonary resection. Inflorescences like those of barley are classed as extrusive because they are so barbed that respiratory movements may carry them through lung tissue and pleura until they finally reach the outside through a sinus. Early symptoms after the aspiration are severe and alarming; pneumonitis invariably appears, often within 24 hours. On the basis of their own experience the authors recommend immediate bronchoscopy. If it fails they advise performing early thoracotomy rather than waiting for spontaneous extrusion.
Clery AP, Ellis FH, Schmidt HW. PROBLEMS ASSOCIATED WITH ASPIRATION OF GRASS HEADS (INFLORESCENCES). JAMA. 1959;171(11):1478–1484. doi:10.1001/jama.1959.03010290036009
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