Nasal Foreign Body

A nasal foreign body refers to an object that has been inserted into the nose and become lodged or stuck, often by a child, but can also occur in adults.

Causes and Risk Factors

• Children under the age of 5 are most commonly affected due to curiosity and exploration of their environment.
• Objects that are small enough to be inserted into the nostril, such as beads, buttons, coins, toys, and food items like peanuts or popcorn kernels.
• Adults may also experience nasal foreign bodies, often due to accidental insertion while trying to remove nasal debris or during recreational activities.

Symptoms

• Nasal obstruction or blockage on one side of the nose.
• Pain or discomfort in the affected nostril.
• Difficulty breathing through the affected nostril.
• Purulent or foul-smelling nasal discharge.
• Sneezing, coughing, or nasal bleeding may occur if the object irritates the nasal mucosa.

Diagnosis

Diagnosis is typically made through a combination of:

• Medical history and physical examination, including visualization of the nasal cavity with an otoscope or nasal speculum.
• Imaging studies such as X-rays may be ordered if the object is radiopaque (visible on X-ray) or if there are concerns about complications like inhalation or aspiration.

Treatment and Removal

The goal of treatment is to safely remove the foreign body from the nasal cavity. Methods include:

• Irrigation with saline solution to help dislodge the object.
• Use of specialized instruments like forceps or a balloon catheter under local anesthesia in a clinical setting.
• In some cases, especially if the object is far back in the nasal cavity or if there are complications, removal may require general anesthesia and an operating room procedure.

Complications

Possible complications of a nasal foreign body include:

• Nasal mucosal irritation or infection.
• Bleeding due to trauma from the object or attempts at removal.
• Inhalation or aspiration of the object, which can lead to respiratory distress or obstruction.
• Damage to the nasal septum or turbinates if the object is sharp or if forceful removal techniques are used.

Prevention

To prevent nasal foreign bodies:

• Supervise children closely, especially during play.
• Keep small objects out of reach of young children.
• Avoid using Q-tips or other objects to clean inside the nose, as this can push an object further into the nasal cavity and cause more harm.