foreign body in the nose

Last reviewed 01/2018

  • young children aged 1 - 4 years may put foreign bodies up one or both nostrils
  • rarely, in an adult, nasal obstruction may be caused by a rhinolith which consists of layers of calcium and magnesium salts formed around a central nucleus - often a foreign body.
  • common nasal foreign bodies include
    • beads, buttons, toy parts, pebbles, candle wax, food, paper, cloth, and button batteries (1)
  • common sites where nasal foreign bodies tend to get lodged are: (1)
    • on the floor of the nasal passage, just below the inferior turbinate
    • in the upper nasal fossa anterior to the middle turbinate
  • clinical features include:
    • foul-smelling nasal discharge (1)
    • discharge may occasionally blood stained
    • excoriation around the nostril
  • management (1)
    • seek expert advice
    • 0.5% phenylephrine can be used to reduce mucosal edema before removal of foreign body
    • topical lidocaine can be applied as an analgesic
    • techniques include removal with direct visualization using
      • forceps
      • curved hooks
      • cerumen loops
      • suction catheters
  • complications
    • there is danger of injury from clumsy attempts at removal by an unskilled person
    • a nasal foreign body carries the danger of inhalation into the lungs and subsequent formation of a lung abscess
    • there may be a local spread of infection to cause a sinusitis or meningitis.

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