Nasal foreign body
Ear Nose | Emergency Medicine | Nasal foreign body (Disease)
Nasal foreign bodies (NFBs) are commonly encountered in emergency departments. Although more frequently seen in the pediatric setting, they can also affect adults, especially those with mental retardation or psychiatric illness. Childrens interests in exploring their bodies make them more prone to lodging foreign bodies in their nasal cavities. In addition, they may also insert foreign bodies to relieve preexisting nasal mucosal irritation or epistaxis. As benign as an NFB may seem to be, it harbors the potential for morbidity, and even mortality, if the object is dislodged into the airway.
Foreign bodies can be classified as either inorganic or organic. Inorganic materials are typically plastic or metal. Common examples include beads and small parts from toys. These materials are often asymptomatic and may be discovered incidentally. Organic foreign bodies, including food, rubber, wood, and sponge, tend to be more irritating to the nasal mucosa and thus may produce earlier symptoms.
The most common locations for NFBs to lodge are just anterior to the middle turbinate or below the inferior turbinate (see the illustration below). Unilateral foreign bodies affect the right side about twice as often as the left. This may be due to a preference of right-handed individuals to insert objects into their right naris.
Causes and Risk factors
The vast majority of foreign bodies are placed in the nose voluntarily for an endless variety of reasons. When questioning children about this possibility, it is important to approach them in a nonjudgmental manner. Otherwise, the adult runs an increased risk that the child will deny having put something in their nose to avoid punishment. This could easily result in a delay of its discovery and increase the risk of complications.
Diagnosis and Treatment
Treatment will largely depend on the location and identity of the object or objects involved. There are a variety of treatment options available; the most common ones are mentioned below and throughout this article.
Commonly used techniques include applying gentle suction to the object, long tweezers, or instruments that have a loop or hook at the tip.