• 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.