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Foreign bodies in the nose are especially often observed in children, and all because it is children who in most cases put pebbles, beads, seeds, buttons, and many other very diverse objects into their nasal cavity. Often children put certain objects not even into their own nasal cavity, but into the noses of children who play with them. In adults, this phenomenon is observed extremely rarely. As a rule, it is a consequence of gunshot wounds or injuries from some household object or bladed weapon. The tip of the weapon in all these cases is fixed in the bone tissue of the nasal cavity, after which it breaks off. If a foreign body was introduced into the nose through the vestibule of this organ, then most often it can be found in the area between the inferior turbinate and the nasal septum. In all other cases, the item can be located anywhere.
Prolonged stay of a foreign body in the nose leads to the fact that over time it becomes overgrown with tissue elements. Such elements in medicine are called granulations. As a result, a nasal stone called rhinolitis. Let us immediately note that rhinoliths can have a very diverse size, as well as different shapes. Sometimes the so-called crypts of the nasal cavity are formed.
An otorhinolaryngological examination helps to identify a foreign body. Sometimes X-rays or computed tomography are performed. These examinations are necessary in the presence of acute sinusitis, the origin of which remains unclear. If a foreign body gets into your nose, immediately close the free half of your nose with your finger and blow your nose thoroughly. If you have any drops on hand that have a vasoconstrictor effect, then before blowing your nose, start by dropping the drops. If this does not help, then call an ambulance as quickly as possible or visit a doctor's office.
The doctor will easily remove any foreign body from your nasal cavity. In this case, before performing the procedure, specialists apply local anesthesia to the mucous membrane of the nasal cavity, after which they remove the foreign object using a special instrument. A hook acts as a special tool, with which you can remove an object in a matter of seconds. Remember, this procedure can only be performed in a medical facility. Under no circumstances do anything yourself, so as not to push the foreign body even further. If a large object gets stuck in the nose, then surgery is most often performed to remove it.
Before use, you should consult a specialist.6515 0
Foreign bodies localized in the nasal cavity are very diverse and are more common in children. As an exception, the presence of living creatures in the nasal cavity - worms, leeches - is described. In most cases, foreign bodies are located in the lower nasal passage and, if no attempts have been made to remove them before, in the anterior sections of the nasal cavity.
In the posterior sections there are foreign bodies that have entered the nose from the nasopharynx. However, foreign bodies can also be localized in the upper parts of the nasal cavity, as well as under the arch of the inferior nasal concha. Foreign bodies enter the paranasal sinuses primarily due to gunshot wounds and puncture wounds, in particular those caused by wooden pointed objects.
A case has been described of foreign bodies entering the maxillary sinus from the side of the tooth socket and from the lower nasal passage through the anastomosis in persons who had undergone a maxillary sinusotomy in the past. In the maxillary sinus there are pieces of wood, rubber, stone, plastics, parts of cereal plants, broken parts of dentures, tampons forgotten during surgery, fragments of dental instruments, etc.
If small, smooth foreign bodies are in the nose, there may not be any unpleasant sensations. Pointed or swelling foreign bodies (peas, beans) can cause nasal pain and headaches. Foreign bodies localized in the paranasal sinuses, in some cases may not cause any changes for several years, in others they lead to the development of purulent sinusitis.
Foreign bodies can cause a one-sided runny nose with purulent discharge, difficulty in nasal breathing, and nosebleeds. Leeches that enter the nasal cavity and nasopharynx cause bleeding, which can be prolonged and persistent. The blood released does not clot.
Diagnosis of a foreign body is not difficult if it is located in the anterior parts of the nose, the mucous membrane is not swollen or bleeding, and the subject remains calm and does not interfere with rhinoscopy. It is not easy to establish a diagnosis in cases where the mucous membrane is swollen and bleeding or granulations have already formed covering the foreign body, as well as when it is located deep.
Metal and other contrasting foreign bodies are clearly visible on radiographs, which, if necessary, are taken in two or three projections. In the presence of non-contrast foreign bodies, contrasting the nasal cavity or paranasal sinuses, and sometimes tomography, can help.
In order to remove a foreign body from the nose, it is necessary to have the appropriate tools, as well as the ability to give anesthesia if necessary. Before removing a foreign body, anesthesia and anemization of the nasal cavity should be performed using a 1-2% solution of dicaine (5-10% solution of cocaine) with adrenaline. (In children, a 3% cocaine solution should be used.)
Removing foreign bodies blindly is unacceptable, as it leads to unnecessary trauma, bleeding and pushing them into the nasopharynx, which is associated with the danger of aspiration. If a foreign body moves towards the nasal part of the pharynx, it is better to carry out further manipulations with the patient lying on his side or insert the index finger into the nasal part of the pharynx.
Removing a foreign body from the nose can begin by trying to blow it out (after anemization) or blowing it with a Politzer balloon through the opposite half of the nose. A gentle method is also to suction the foreign body through the vestibule of the cervical sinus using special tips [Shakhov V. Yu. et al., 1983]. If it is not possible to achieve the desired result in this way, then instrumental removal is indicated.
When removing a foreign body from a child, it must be well fixed. Round foreign bodies are quite easily removed with a button-shaped probe curved at the end (attic probe with a straight handle, Lange hook). For convenience, a nasal button probe or a piece of wire with a curved, appropriately blunted end can be inserted into the handle of the laryngeal speculum. Oblong or flat foreign bodies are captured by the nasal or ear pliers; a magnet can be used to remove iron objects. Rough foreign bodies can sometimes be removed using a nasal polyp loop. Rhinoliths often have to be crushed because they do not pass from the nasal cavity to its vestibule.
Leeches are removed with forceps. First, apply a 10% sodium chloride solution into your nose; the leech is separated from its attachment site. Removal of large foreign bodies (bullets, fragments of mines and shells), as well as foreign bodies from the paranasal sinuses, is carried out by typically opening the corresponding sinus. The approach to the nasal cavity is through the maxillary sinus; as a rule, the ethmoidal labyrinth is simultaneously opened.
IN. Kalina, F.I. Chumakov
There can be only one reason for the appearance of a foreign body in a child’s nose - the independent insertion of small objects and bones into the nose. Traumatic exposure to a foreign body occurs only in adults or adolescents when working in production, in a metal shop, playing at a shooting range, and so on, when a foreign body forcefully pierces the skin and nasal cartilage. In this situation, the patient should be urgently taken to the hospital for surgical removal of the foreign body.
Symptoms of having a foreign body in the nose
If a foreign body has sharp ends, then children usually complain of pain from the point where they inserted the object. At the same time, children do not always admit to what they have done. Therefore, try to calmly ask your child what happened. Look into the nostril, perhaps you yourself will find a foreign body in the nose. If you notice an object or the child himself admits it to you, then proceed as described below. If not, then take your child to the doctor immediately.
If the mucous membrane is damaged, bloody discharge will appear from the nose. In some cases, there may be nosebleeds. In this situation, immediately take the child to the doctor.
But a foreign body in the nose does not always damage the mucous membrane or is accompanied by pain. Much more often the child does not feel anything for a long time. It is not uncommon for an object to remain in the nose for quite a long time until it begins to decompose or becomes a nucleus for the accumulation of nasal fluid and bacteria (rhinolitis formation).
Symptoms of prolonged presence of a foreign body in the nose
The child develops a one-sided runny nose with an unpleasant odor. There may be pain radiating to the cheek, ear and throat. In some cases, low-grade fever may appear. Unfortunately, many parents begin to treat their child for ARVI instead of examining him and finding out the cause of the symptoms mentioned. If the object is not removed at this stage, inflammation of the paranasal sinuses and even ulceration of the mucous membrane may develop in the future.
Diagnosis of a foreign body in the nose
Rhinoscopy.
- Probing.
- X-ray examination.
But usually a foreign body in the nose is easily identified upon examination.
Removal of a foreign body in the nose
First aid at home
The most important thing is don't panic. Ask your child to breathe through his mouth to prevent the object from going deeper under the influence of the air current. If the foreign body is soft, then you can try to remove it with tweezers. If it's hard and/or smooth, then don't even try it. You will almost certainly push it deeper. If the child knows how to blow his nose correctly, then ask him to do it. When he blows his nose, let him tilt his head down. If the baby is too small, then, on the contrary, tell him not to do this and to breathe through his mouth. If all attempts to get the item are unsuccessful, then take the child to the doctor.
Medical assistance
If the foreign body of the nose is small, then it is removed with a special medical blunt hook. Flat or soft foreign bodies are removed with medical tweezers. Round objects are removed with a thick button probe or ear spoon. The object can also be sucked out with a special device. Using the Politzer douche (air blowing) method to remove a foreign body from the nose is incorrect. In more complex situations, they may crush the object before removing it, and then take it out in parts.
Very important!
After removing a foreign body from the nose, anti-inflammatory therapy is necessary, even if you removed the object yourself at home. In mild cases, you can use drops from herbal infusions for a week. In more serious situations, antibiotic drops are prescribed.
Prevention
Do not let small children play with small objects. Serve the fruit after removing the seeds. Try to explain to your child that nothing should be put into the nose.
Foreign bodies in the nasal cavity occur mainly in young children (up to 5-7 years).
What provokes / Causes of Foreign bodies in the nose:
While playing, children stick various objects into their own and their peers' noses. Sometimes foreign bodies enter the nose due to injury or vomiting through the nasopharynx. It is extremely rare that impacted teeth are found in the nasal cavity as a result of a violation of their development. In older children, small tampons are sometimes found in the nose, left after the nosebleed has stopped. Foreign bodies entering the nasal cavity are possible with penetrating facial wounds. A foreign body can penetrate into the choanae due to inept attempts to remove it from the nasal cavity.
Pathogenesis (what happens?) during Nasal Foreign Bodies:
Foreign bodies in the nose are extremely varied in shape, size and character.
- Organic (pieces of food, fruits, vegetables, seeds of cereal plants, fruit seeds, pieces of paper, matches, etc.).
- Live foreign bodies (insects, leeches, worms, larvae).
- Inorganic (small buttons, beads, stones; parts of plastic toys; pieces of foam rubber, sponges, paper, cotton wool).
- Metal (coins, buttons, badges, screws, buttons, pins, needles, nails, fragments of firearms, etc.).
- Radiopaque and non-contrast.
Symptoms of Nasal Foreign Bodies:
Foreign bodies are mostly localized in the general nasal passage, but can be in the lower or middle nasal passage, in the vestibule of the nose and deep in the posterior parts of the nasal cavity, in the area of the choanae.
The main, and sometimes the only, sign of a foreign body in the nasal cavity is unilateral nasal congestion.
When foreign bodies stay for a long time, purulent discharge mixed with blood appears, a sharp putrid odor from the corresponding half of the nose, especially with decaying organic foreign bodies, and skin irritation in the area of the entrance to the nose.
Initial reactions to a foreign body (sneezing, lacrimation, unilateral watery discharge) usually disappear quickly.
Prolonged stay of a foreign body in the nasal cavity leads to the formation of rhinoliths (nasal stones) as a result of deposition of phosphate and calcium carbonate with the development of reactive inflammation of the mucous membrane and the formation of bleeding granulation tissue. Rhinosinusitis develops, and in rare cases osteomyelitis.
Unsuccessful attempts to remove a foreign body are accompanied by trauma to the mucous membrane, bleeding, and movement of the foreign body into the deeper parts of the nasal cavity, into the nasopharynx, from where it can enter the respiratory tract and esophagus.
Diagnosis of Nasal Foreign Bodies:
Diagnosis is based on medical history, endoscopy, and, if necessary, radiography of the nasal cavity. To identify contrast foreign bodies, simple radiography is performed, if an organic foreign body is suspected, with a contrast agent. Radiography makes it possible to establish not only the presence of a foreign body, but also its nature and location.
Identification of a foreign body in children is made difficult by the lack of anamnestic data, since foreign bodies often enter the nose in the absence of adults. Fearing punishment, children often hide this from their parents, and later forget, and only when the disease develops do all its circumstances become clear.
A long-term unilateral purulent process in the nasal cavity in a child should always alert doctors to the possibility of a foreign body.
The most reliable diagnostic method remains anterior and posterior rhinoscopy, as well as fibrorhinoscopy when a foreign body is located in the posterior parts of the nasal cavity. In such cases, the mucous membrane of the nasal cavity is first thoroughly anemized with a solution of adrenaline to reduce swelling. If even after this the foreign body cannot be detected, carefully probe the suspicious area with a button probe after local anesthesia, which gives a positive result only for solid foreign bodies.
Differential diagnosis. Differentiate with diseases of the paranasal sinuses, nasal diphtheria and neoplasms.
Treatment of Nasal Foreign Bodies:
Nasal foreign bodies are removed on an outpatient basis; in case of complications, patients are hospitalized.
The simplest and most accessible way is to blow your nose (especially if the foreign body is not large) after instilling a vasoconstrictor solution.
If the foreign body is not released, it is removed under local anesthesia using a blunt hook, which, under visual control, is inserted from above behind the foreign body and removed with a sliding movement along the bottom of the nasal cavity.
In difficult cases, this operation is performed under anesthesia, especially after repeated unsuccessful attempts, with large wedged or sharply pointed foreign bodies, as well as in children with neurotic reactions.
Due to the possibility of a foreign body being displaced into the deep parts of the nose, the nasopharynx and respiratory tract, it is prohibited to remove round foreign bodies from the nose with forceps or tweezers. This does not apply to foreign bodies of other shapes (pieces of paper, rubber, matches).
Rhinolith is removed in the same way. Large rhinoliths are first crushed with forceps in the nasal cavity.
Which doctors should you contact if you have Nasal Foreign Bodies:
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Other diseases from the group Diseases of the ear and mastoid process:
| Brain abscess |
| Cerebellar abscess |
| Adhesive otitis media |
| Adhesive otitis media |
| Ludwig's tonsillitis |
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| Laryngeal sore throat |
| Diphtheria of the pharynx |
| Diphtheria of the nasal cavity |
| Zygomaticitis |
| Malignant tumors of the outer ear |
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| Neuroma of the vestibulocochlear nerve |
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| Nose bleed |
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| Acute sinusitis |
| Acute purulent otitis media |
| Acute primary tonsillitis |
| Acute rhinitis |
| Acute sinusitis |
| Acute otitis media in children |
| Acute serous otitis media |
| Acute sphenoiditis |
| Acute pharyngitis |
| Acute frontal sinusitis |
| Acute ethmoiditis |
| Otoanthritis |
| Otogenic brain abscess |
| Otogenic meningitis |
| Otogenic sepsis |
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| Perichondritis of the external ear |
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