Nose Treatment

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.
    • Types of foreign bodies:
      • 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.
Clinical features:
  • Early:
    • Subacute presentation: Subacute presentation is with a foul smelling unilateral nasal discharge not responding to treatment.
    • Excoriation of affected nares.
    Late Presentation:
    • Retained foreign bodies in adults present as unilateral nasal congestion and discharge.
    • Sinusitis.
    • 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.
Therapeutic:
Procedure for nasal foreign body removal:
  • 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.
  • 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.
  • FESS may be required for embedded foreign bodies to remove them under direct vision.
Image

Book Your Appointment