Pediatric Nasal Foreign Bodies

Many of my pediatric patients with nasal foreign bodies present to the emergency department for chief complaints unrelated to the nose. The young man shown below, for example, presented several years ago for the evaluation of dog bite wounds to the face. I could see the telltale signs and symptoms of a chronic unilateral nasal drainage the minute I walked in the room. (Figure 1.) Figure 1. Nasal drainage is the telltale sign of a nasal foreign body.   I questioned the patient and his father, and they offered no history to confirm insertion of a nasal foreign body. Nevertheless, a wad of mummified Halloween candy wrappings inserted a month earlier was removed after significant effort that required the assistance of our ENT colleagues. (Figure 2.) Figure 2.   The family will uniformly complain that the patient has an offensive body odor after the nasal foreign body has been present for weeks to months. A purulent unilateral nasal drainage will also be observed and reported. The foreign body can be found in any area of the nasal cavity, but will most predictably be located below the inferior turbinate or immediately anterior to the middle turbinate.   Three different types of techniques are used to remove a foreign body: manual removal with a curette, forceps, hemostats, or suction; positive air pressure techniques, and balloon catheter techniques. The equipment that may be required for the different techniques are: • Bulb syringe• Katz extractor• Alligator forceps...
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