FOREIGN BODY NOSE
Foreign body in nose can present acutely, sub-acutely or many years later in adulthood.
Aetiology:
- Age: Usually found in children between 2-5 years of age.
- Site: Foreign bodies commonly lodge between septum and inferior turbinate or between the septum and middle turbinate if they are pushed deep into the nose.
- Organic foreign bodies: Tissue paper, seeds, sponge, peas etc. They provoke an intense inflammatory reaction from the nasal mucosa.
- Inorganic Material: Beads, button, rubbers, wooden pieces require careful removal.
- Battery: Button cell battery inserted in the nasal cavity requires urgent examination under anesthesia. Leakage from the battery can result in corrosive burns and destruction of the nasal septum.
1.Early:
a) Subacute presentation: Subacute presentation is with a foul smelling unilateral nasal discharge not responding to treatment.
b) Excoriation of affected nares. 2. Late Presentation: a. Retained foreign bodies in adults present as unilateral nasal congestion and discharge.
b. Sinusitis.
c. Rhinolith formation, due to deposition of calcium and magnesium salts around the foreign body.
b) Excoriation of affected nares. 2. Late Presentation: a. Retained foreign bodies in adults present as unilateral nasal congestion and discharge.
b. Sinusitis.
c. Rhinolith formation, due to deposition of calcium and magnesium salts around the foreign body.
Investigations:
- Nasal foreign bodies are usually visible on anterior rhinoscopy.
- CT Scan PNS may demonstrate a radio-opaque or impacted foreign object.
- X-ray paranasal sinuses may reveal pan-sinusitis.
- Most subacute foreign bodies are removed as an OPD procedure by inserting a Vectis or a nasal foreign body hook behind the foreign body and sweeping it along the floor of the nose.
2. Foreign bodies which are long standing must be extracted under general anesthesia as they are impacted and can cause some amount of bleeding and pain.
3. FESS may be required for embedded foreign bodies to remove them under direct vision.
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