Foreign Bodies

Antibiotic drops for the ear may be prescribed to treat any possible infections.

Objects that are put into the child's nose are usually soft things. Sometimes, a foreign body may enter the nose while the child is trying to smell the object. The most common symptom of a foreign body in the nose is nasal drainage.

The drainage appears only on the side of the nose with the object and often has a bad odor. In some cases, the child may also have a bloody nose.

Foreign Bodies in the Ear, Nose, and Airway

Treatment of a foreign body in the nose involves prompt removal of the object by your child's healthcare provider. Sedating the child is sometimes necessary in order to remove the object successfully. The following are some of the techniques that may be used by your child's healthcare provider to remove the object from the nose:. After removal of the object, your child's healthcare provider may prescribe nose drops or antibiotic ointments to treat any possible infections.

The foreign body can get stuck in many different places within the airway. As with other foreign body problems, children tend to put things into their mouths when they are bored or curious. The child may then inhale deeply and the object may become lodged in the "airway" tube trachea instead of the "eating" tube esophagus. Food may be the cause of obstruction in children who do not have a full set of teeth to chew completely, or those children who simply do not chew their food well.

Children also do not have complete coordination of the mouth and tongue, which may also lead to problems. Children under the age of 4 years are in the greatest danger of choking on small objects, including:. Foreign body ingestion needs immediate medical attention. The following are the most common symptoms that may indicate a child is choking:.

Although the initial symptoms listed above may subside, the foreign body may still be obstructing the airway. The following symptoms may indicate that the foreign body is still causing an airway obstruction:. Treatment of the problem varies with the degree of airway blockage. This is a medical emergency and you should seek emergency medical care. Sometimes, surgery is necessary to remove the object. Children who are still talking and breathing but show other symptoms also need to be evaluated by a healthcare professional immediately.

Foreign Bodies in the Ear, Nose, and Throat An infant or young child may put an object in his or her ears, nose, or mouth. Rarely parasitic or larvae infections can be present in the nose. There is a slightly higher incidence in boys. Unilateral foreign bodies are found on the right side twice as often as the left probably due to right-handedness.

Rarely, more severe complications can occur including preseptal cellulitis, meningitis, epiglottitis, diphtheria, and tetanus. Failure to remove in the emergency department is higher with spherical or disk-shaped objects and if more than one attempt or instrument is used. The average time to removal is 9. Children with autism spectrum disorder commonly repeatedly insert foreign bodies into various orifices.

They may also have multiple objects on multiple sites. Repeated insertion of objects into the nose or other orifices can be associated with psychiatric illness. The foreign body produces local inflammation that can lead to pressure necrosis. Mucosal ulceration can then progress to erosion into blood vessels causing epistaxis. If the object becomes displaced posteriorly, it can enter the respiratory tract with secondary morbidities.

Nasal foreign bodies can become calcified known as a rhinolith. Organic objects cause a brisk inflammatory response. Each year, more than button batteries are ingested in the United States. They are small and shiny and very appealing to children.

Foreign Bodies: MedlinePlus

Tissue damage occurs as direct leakage causes corrosive damage. There are also direct current effects on the mucosa and pressure necrosis. Paired magnets also create a current with similar results. There may be a septal perforation in as little as 4 hours. They may also be sneezing, snoring, fever or coughing. Younger children may only present with irritability.

The axiom that a unilateral, foul-smelling nasal discharge is a foreign body until ruled out holds true. Removal of nasal foreign bodies requires a bright light source, preferably a headlamp. Conscious sedation may be considered, but the foreign body has the potential to dislodge and cause aspiration under sedation posteriorly. Ability to provide for an advanced airway is a prerequisite. The use of a topical vasoconstrictor may help visualize the object, control bleeding and decrease secretions. A nasal speculum, various size probes, curettes, and alligator forceps are necessary.

The most commonly used is direct visualization and extraction using instrumentation.

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Curettes, alligator forceps, or probes are best used in this fashion. The object can be pulled directly out using alligators as in the case of paper or sponge material. Forced exhalation is another method that may utilize either the parent or a bag-valve mask BVM. A BVM can be used in the same fashion with a tight seal.

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Suction can be used to remove or bring an object lower into the nasal passages. Flexible suction catheters or Yankhauer can be used depending on the size of the patient. Glue can be used on a very cooperative patient. A small amount of glue is placed on a cotton swab and applied to a spherical, well-visualized object and pulled forward. A patient should be referred to an otorhinolaryngologist ENT when button batteries, magnets, as well as posteriorly displaced objects are lodged.

They may require nasal endoscopy or removal in the operating room. Educating families about the risk of button batteries is important.

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Adult supervision is always the key to prevention. The majority of cases of nasal foreign bodies are seen in the emergency department.

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If the nasal foreign body dislodges, it can block the airway and lead to an immediate fatality; hence nurses and physicians in the emergency room have to be aware of the potential consequences of this diagnosis. The majority of nasal foreign bodies can be removed in the emergency department without any sequelae.

However, if there is any difficulty in removing the foreign body an ENT consult should be made. Small case series report that complications are rare when the foreign body is removed from the nose promptly but any delay can lead to a number of complications. To access free multiple choice questions on this topic, click here. This book is distributed under the terms of the Creative Commons Attribution 4.

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