Foreign Body, Nasal

Basics

Description

  • Object impacted in the nasal cavity
  • Most common site of foreign body insertion in children
  • Type of foreign body limited only by nostril size
  • Can be missed and remain for weeks or months
  • Usually located at the floor of the inferior turbinate or anterior to the middle turbinate
  • Population at risk:
    • Children between 2–6 yr most common
    • Mental retardation
    • Psychiatric illness
  • Causes of worsening impaction and difficulties with removal:
    • Organic material may expand if moistened
    • Mucosal swelling over time
  • Complications:
    • Sinusitis is the most common complication
    • Foreign bodies may migrate into the sinuses
    • Septal perforation
    • Bronchial aspiration
    • High risk of complications with button batteries:
      • Mucosa ischemia
      • Turbinate or septal damage
      • Saddle-nose deformity

Etiology

  • Organic vs. inorganic
  • Food
  • Beans
  • Seeds
  • Beads
  • Rocks
  • Paper
  • Pieces of toys
  • Sponge pieces
  • Vegetable matter
  • Insects and live worms (rare)
  • Button batteries:
    • High risk of complications compared with other foreign bodies (tissue necrosis, septal perforation, saddle-nose deformity); require rapid removal
    • Septal perforation can occur in as little as 4 hr
  • Magnets:
    • Used to mimic nasal piercing
    • Often imbedded in nasal tissue, leading to difficult removal
    • May cause intestinal perforation if swallowed, especially newer high-power neodymium magnets
  • Glass fragments

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