Foreign body in the nose - how to remove it without consequences? Foreign body in the maxillary sinus. Feeling like something is stuck in the nose.

Foreign objects getting into the nose is one of the most common reasons for visiting pediatric otolaryngology. But even adults are not immune from such a diagnosis. While children can purposefully place foreign bodies into the nasal cavity, in adults this phenomenon is most often accidental.

About pathology

A foreign body (FB) in the nose can be placed purposefully or accidentally. Moreover, this condition often occurs completely asymptomatic at first.

Then, over time, signs of a foreign object in the nose develop. Despite this, most often the symptoms of this phenomenon are quite bright, due to which the ENT doctor, after examination, removes the foreign body from the cavity.

Naturally, this condition is most often observed in children. As a rule, during games they place small parts of toys, beads, coins, fruit pits in the nose.

In 80% of cases, trapped objects are located in the lower part of the nasal passage. It happens a little less often that one end of a foreign body is wedged into the lower part of the nasal concha, and the other into the nasal septum. If a foreign body is accidentally introduced, it can be located in any location.

Classification of foreign bodies in the nose

Foreign bodies are classified into:

• Inorganic - beads, beads, pebbles, plastic, and so on;
• Organic - leaves, seeds, peas, seeds, etc.;
• Metal - coins, construction parts, nails, needles, and so on;
• Live – midges, roundworms, leeches, larvae.

Depending on how objects appear on x-rays, they are divided into radiopaque and radiopaque. The latter include living foreign bodies.

Foreign body in the nose, what you need to know:

Causes

The reasons for foreign objects entering the nasal cavity are:

• Targeted introduction;
• Accidental inhalation;
• Objects left behind after medical procedures (including the patient’s own tissue);
• while eating (when a person chokes);
• Entry through vomit.

There are many reasons for this development of events. Only children, as well as people with mental disabilities, do this purposefully. But foreign objects do not appear randomly so often. It is not uncommon that with the help of protective reactions of a mechanism such as sneezing, it is possible to get rid of IT in the nose.

Symptoms

Symptoms are often confused by people with allergies, which in general, in a sense, is what it is. In essence, an irritant is the same foreign body that the body tries to remove in every possible way.

Therefore, when a foreign object gets into the nasal passages, many experienced the following symptoms:

• Tearing.

Symptoms often go away within a short period of time. After this, the foreign object may not bother the patient. Only one-sided is present. Painful sensations make themselves felt less often and only when the object has sharp ends.

If a person does not see a doctor, chronic irritation and injury to the mucous membranes develops, after which an inflammatory reaction develops. It leads to the development of the usual symptoms - pain in the nose, mucopurulent secretion discharged from one half of the nose, swelling and difficulty in nasal breathing in general.

But in some cases, typical symptoms appear almost immediately after IT gets into the nose:

• Irritation;
• Sensation of a foreign object in the nose;
• Pain in the affected half of the nose;
• Pain can radiate to the eye, forehead, cheek, or throat.

If the internal tissues are significantly damaged, nosebleeds may develop. Painful sensations also lead to sleep disturbances, increased irritability, moodiness, tearfulness, and anxiety (especially in children).

Unlike other types of pathologies of the nasal passages and sinuses, the manifestations are one-sided. The danger of the condition is that when you try to inhale, the FB may move into the larynx or pharynx.

Some foreign objects may undergo changes, for example, peas, beans may increase in size due to increased humidity, and some, on the contrary, fall into pieces, soften and completely decompose. If IT retains its appearance, then it often becomes the core of a nasal stone, overgrown with salt crystals from nasal secretions.

If the object is present for a long time, tissue granulation often develops, which as a result hides the foreign object during examination, preventing a correct diagnosis.

First aid

If a person has inserted a foreign object into the nasal passage, it is necessary to examine it. If an object is found almost at the outer part, it is necessary to carry out first aid. If this is not possible or the object is embedded tightly and deeply and tends to disintegrate or split, then it is better to consult a doctor.

Surgical method for removing a foreign body in the nose:

Algorithm of actions

If you cannot see a doctor, you must:

• It is necessary to instill a vasoconstrictor drug into the nasal passage in the form of drops (a spray can aggravate the situation, they will push IT further).
• If the child cannot follow commands, you need to close the healthy nostril (pressing it against the septum), and then take a sharp breath into the mouth. This action can help push the object out of the nose.
• If the child is older, you need to ask him to stop breathing through his nose and take a deep breath through his mouth. Next, pinch the healthy nostril with your finger and ask to exhale sharply through the nose. If at the same time the child feels that the object is moving, then repeat the action until the nasal passage is freed from the IT.
• If the procedure was not successful, you can drop Kalanchoe into the child’s nose or let him breathe in ground pepper.

If these actions do not lead to success, you should immediately consult a doctor or call emergency help. The child should be reminded that he needs to breathe through his mouth. It is forbidden to give food or drink at the same time.

Foreign body in the nose

What not to do

Do not do this if you have IT in the nose:

• Remove the item using your finger, cotton swab or tweezers;
• Press on the nostril with IT;
• Rinse your nose with water.

With such actions, a change in the location of the object or injury to the nasal tissue will be almost inevitable. In this case, there is a risk of developing a massive type. In this case, you need to call an ambulance.

It should also be understood that even if a foreign object is removed from the nasal passage, the symptoms will persist for some time. If the signs of IT do not subside within 24 hours, you need to contact an ENT doctor, as there is a risk of leaving any of its parts in the nasal cavity or severe tissue injury.

Method for removing a foreign body in the nose

Diagnostics and necessary studies

It is necessary to visit an otolaryngologist, who will examine the patient, as well as:

• Will hold ;
• Order an x-ray;
• Probing with a metal probe;
• Analysis of nasal secretions (bacteria culture);

Extraction Methods

Removal of a foreign object is carried out:

• using a hook. Local anesthesia is performed, and in the case of small children, general anesthesia.
• If endoscopy is unsuccessful, surgery is used.

Additionally, nasal rinsing, sinus rinsing and drainage, and treatment of complications can also be used only in an ENT doctor’s office.

Why is a foreign body in the nose dangerous?

First of all, a foreign body in the nasal sinus is dangerous precisely because of the increased risk of the object moving into the pharynx or larynx, which can lead to suffocation.

But keeping an object in the nasal passage for a long time leads to:

• Ulceration of the mucous membrane;
• Necrosis of the nasal concha;
• Suppuration of the lacrimal sac;
• Impaired functionality of the tear ducts;
• Attachment of a secondary infection;
• Purulent;
• Osteomyelitis of the nasal bones;

The longer treatment is not carried out, the higher the risk of developing severe pathological conditions.

Parents should not:

• Leaving children unattended;
• Giving toys that are not appropriate for age, especially small parts of construction toys often end up in the nose;
• Give berries or fruits with seeds that the child can put in his nose or choke on;
• Remove the fallen object “manually”.

It should be remembered that inept actions of parents can lead to much more serious complications and complicate the doctor’s further work.

Forecast

When correctly removing an object from the nose, the prognosis is generally positive. If the object had sharp parts or corners, then injury to the mucous membranes can lead to various types of complications. If treatment is not carried out, the risk of developing other pathological conditions increases significantly.

How to remove a foreign body in a child’s nose:

Alternative names: removal of a foreign body from the ENT organs, removal of a foreign body from the nasal cavity, removal of foreign bodies from the ENT organs using an endoscope.

Foreign bodies in the nasal cavity, oropharynx, and ear are a problem in pediatric otorhinolaryngology. According to statistics, parents of children aged 2-7 years most often encounter this problem. The most common reason is playing with small objects. Coins, buttons, pieces of paper, plant seeds and other objects can get into a child's nose.

Clinical manifestations of foreign bodies in the nasal cavity

Parents may not always notice the moment a foreign body enters the child’s nose. At a more conscious age (after 4 years), the child can complain himself. But there are often situations when even adult children, due to fear of punishment, do not complain about foreign objects getting into their noses.

You can suspect a foreign body in the nose if the following symptoms appear:

When a foreign object remains in the lower nasal passage for a long time, the following phenomena are observed:

• bloody and purulent nasal discharge, often with a putrid odor;
• development of sinusitis;
• swelling of the nose.

The appearance of these signs indicates the development of complications.

Why are foreign bodies in the nasal cavity dangerous?

A foreign body in the nasal cavity becomes a place of concentration of dust and bacteria. In the absence of normal air circulation and with impaired discharge of mucus from the nasal passage, local inflammation with suppuration develops. The process can spread to the air sinuses - sinusitis develops.

If a foreign body remains in the nasal passage for a long time, deformation of the nasal septum may develop, which will subsequently lead to severe disturbances in nasal breathing.

Any foreign body in the nasal cavity must be removed - the sooner the better.

Preparing for removal

To confirm the diagnosis, anterior (direct) and posterior rhinoscopy are performed; it is advisable to perform endoscopic rhinoscopy. If radiopaque foreign bodies are suspected, radiography is necessary. However, with its help it is impossible to see X-ray negative objects (wooden, plastic, plant seeds, etc.).

In preparation for the removal of a foreign body, vasoconstrictor drops are instilled into the nasal passages. For adult patients and older children, the procedure can be performed while conscious; in order to reduce discomfort, a local anesthetic solution can be dripped into the nasal passage. For young children, it is recommended that nasal foreign bodies be removed under general anesthesia.

How foreign bodies are removed from the nose.

In the simplest case, the foreign object is removed using a hook through the anterior nasal passage. The hook is wound around the foreign body, after which it is brought out. It is categorically not recommended to try to remove a foreign body with tweezers, since this is a very high risk of pushing the object even deeper.

In more complex cases, when the foreign body is large, is located with a wedge, or there is a deformation of the nasal passages that makes removal difficult, endoscopic techniques are used. In this case, a thin endoscope is inserted into the nose, with the help of which the exact location of the foreign body is determined. Special forceps are passed through the working channel of the endoscope, with which you can hook the object and remove it out.

In some cases, the foreign body can be removed by blowing your nose. However, this method is only suitable for adult patients. After two or three unsuccessful attempts at blowing, you should stop and seek help from a doctor.

Prevention of complications

Even a short stay of a foreign object in the nose injures the mucous membrane.

To prevent inflammatory complications, the following is prescribed:

Literature:

A foreign body in the nose is any object that has somehow entered the nasal cavity. Very often children try to insert small objects into their noses. Most often, after long attempts, they manage to do it. After this situation, parents may immediately detect it, or they may not even realize for a long time that there is a foreign body in their child’s nose.

Causes

During the game, it happens that children often stick various objects into the noses and into the noses of their peers. In some cases, a foreign body enters the nose due to injury or during vomiting through the nasopharynx. In very rare cases, impacted teeth end up in the nasal cavity due to disruption of their development. In older children, you can find tampons in the nose, which are left after the nosebleed has stopped. Foreign bodies can also enter the cavity during a penetrating wound to the face. A foreign body can penetrate into the choanae if attempts are made to remove it unsuccessfully.

Foreign bodies in the nose vary greatly in size, shape and character. Among them are:

• Live foreign bodies. For example: leeches, larvae, worms;
• Metal foreign bodies - buttons, screws, coins, badges, pins, buttons, nails, needles;
• Organic - pieces of vegetables and fruits, fruit seeds, matches, seeds of cereal plants.
• Inorganic - small beads, buttons, stones, pieces of cotton wool, foam rubber, paper, sponges.
• Non-contrast and radiopaque.

Symptoms of this disease

Mostly, foreign bodies are localized in the nasal passage, less often they can be located in the middle or lower nasal passage, in the choanae, in the vestibule of the nose, deep in the posterior parts of the nose. A very important sign of the presence of a foreign body in the nose is nasal congestion, which appears on one side. If a foreign body remains in the nose for a long time, a purulent process begins to develop. Purulent discharge with blood appears. A putrid, pungent odor arises from the half of the nose where the foreign body is located. The odor is enhanced by decomposing organic foreign bodies. In the area near the entrance to the nose, irritation occurs as the child constantly scratches it.

Initial reactions to a foreign body entering the nose include lacrimation, sneezing, and watery discharge on one side. These symptoms do not appear for a long time and quickly disappear.

In case of prolonged presence of a foreign body in the nasal cavity, rhinoliths - nasal stones - are formed. They arise as a result of the deposition of calcium carbonate and phosphate with the development of a reactive inflammatory process of the mucous membrane. Bleeding granulation tissue also develops. Rhinosinusitis and sometimes osteomyelitis occur.

If an attempt to remove a foreign body is unsuccessful, then the process is accompanied by bleeding, injury to the nasal mucosa, and entry of the foreign body into the nasopharynx and into the deeper parts of the nasal cavity. From these places, a foreign body has the opportunity to enter the food and respiratory tract.

Diagnosis of a foreign body in the nose

The basis for diagnosing this disease is taking a medical history and endoscopy. If necessary, an x-ray of the noma cavity is performed. In order to identify foreign bodies, simple radiography is performed. If there is a suspicion of the presence of an organic foreign body, a contrast agent is used.

By performing radiography, it is possible to establish the presence of a foreign body, its location and nature.

Identifying a foreign body in children is a little difficult, since there is not enough anamnestic data. A foreign body can enter a child's nose without the presence of parents. Children, fearing that they will be punished, hide this from their parents, and soon forget about it. The circumstances are clarified only after the development of the disease. Doctors should be wary of a long-term purulent process in the baby’s nasal cavity in terms of a foreign body.

The most accurate diagnostic methods are posterior and anterior rhinoscopy and fibroendoscopy, in the case of a foreign body located in the posterior part of the nasal cavity. In this case, the nasal mucosa is thoroughly anemized with a solution of adrenaline to reduce swelling. If the foreign body cannot be detected after this, then probe the suspicious area using a button probe. This process is carried out after applying local anesthesia.

Treatment of a foreign body in the nose

If you find a foreign body in your child’s nose, do not panic. You need to ask him to breathe through his mouth so that under the influence of the air current the foreign body does not go even deeper.

Foreign bodies are removed from the nasal cavity on an outpatient basis. If any complications arise, the patient must be hospitalized. The most accessible and simplest way is to simply blow your nose. This method is especially effective in cases where the foreign body is large. Before the procedure, you need to drip a vasoconstrictor solution into your nose. If the foreign body is not released, then it is removed from the child’s nose using a blunt hook, after applying local anesthesia. The hook is inserted from above behind the foreign body under visual control and removed along the bottom of the nasal cavity with sliding movements.

In very difficult cases, if repeated attempts to remove the body have ended unsuccessfully, the operation is performed under anesthesia. Anesthesia is also used if foreign bodies have a sharp end and can damage the nasal cavity.

Due to the fact that there is a risk of foreign bodies being displaced into the nasopharynx or into the deep parts of the nose, respiratory tract, round-shaped foreign bodies from the nose must not be removed using tweezers or forceps. But this does not apply to foreign bodies of other shapes. Rhinolith is removed in the same way. Before removal, large rhinoliths are crushed in the nasal cavity with pincers.

After a foreign body has been removed from the nose, it is imperative to carry out anti-inflammatory therapy, even if the removal took place at home. In mild cases, you can use drops based on herbal infusions for one week. If the situations are more serious, then antibiotic drops are prescribed.

Prevention

Care must be taken to ensure that the child does not play with very small toys. The baby should be given fruits after removing all the seeds from them. If the child is older, try to explain to him that nothing should be inserted into the nose.

A foreign object that has accidentally entered the nasal cavity: a bead, a berry seed, a seed, a small part of a toy, a mosquito or other insect, a piece of wood, plastic, food, cotton wool or paper. A foreign body in the nose may be asymptomatic. But more often it manifests itself as pain, one-sided nasal congestion and discharge from the affected half of the nose. Diagnosis of a foreign body in the nose is helped by medical history, results of otolaryngological examination and rhinoscopy, CT and radiography data. Treatment of a foreign body in the nose consists of its removal as early as possible by blowing, endoscopic or surgical removal.

General information

Most often, specialists in the field of pediatric otolaryngology have to deal with foreign bodies in the nose. Children, while playing, deliberately insert various objects into their own and each other's noses. Foreign bodies that enter the nasal cavity in this way are usually located in the lower nasal passage. They make up 80% of the total number of foreign bodies in the nose. Less commonly observed are foreign objects wedged into the nasal septum at one end and into the inferior turbinate at the other. A foreign body in the nose that accidentally gets into it can have any location.

Pathogenesis

Foreign body entry into the nose can occur naturally from the environment through the nostrils and from the pharynx through the choanal openings. Foreign bodies in the nose that have entered through the nostrils are found mainly in preschool children who, for fun, put various small objects into their noses. Living organisms in the inhaled air or in water from open sources and reservoirs can accidentally enter the nose. In some cases, a nasal foreign body is iatrogenic in nature and is a cotton swab left in the nose or a broken part of a surgical instrument used during otolaryngological manipulations or operations (septoplasty, correction of choanal atresia, resection of the nasal concha, removal of a tumor of the nasal cavity, etc.).

A foreign body in the nose can result from choking while eating or vomiting. In this case, pieces of food or other objects located in the pharyngeal cavity can be thrown into the nose through the openings of the choanae connecting the nose to the pharynx. The appearance of a foreign body in the nose is also possible due to trauma to the nose and damage to the adjacent facial structures. In this case, a foreign body in the nose can be a piece of glass, a piece of wood, a sharp object, a bullet or a loose piece of bone.

Classification of foreign bodies in the nose

By their nature, foreign bodies in the nose are classified into: inorganic (pebbles, beads, beads, cotton wool, pieces of glass, plastic parts), metal (coins, screws, parts of a metal constructor, needles, nails, buttons, fragments of firearms), organic (seeds various plants, peas, small beans, pieces of vegetables and fruits, fruit seeds, parts of food products), live (insects, larvae, leeches, roundworms).

Depending on whether a nasal foreign body is visualized during X-ray examination or not, radiopaque and radiopaque foreign bodies are distinguished. Radiopaque bodies include metal objects, glass, bones, buttons, and parts of toys.

Symptoms of a foreign body in the nose

Typically, the entry of a foreign object into the nasal cavity is accompanied by reflex sneezing, watery discharge from one half of the nose and lacrimation. However, these symptoms quickly pass and in the future the foreign body in the nose may not bother the patient at all. A small foreign body of the nose, which has a smooth surface, may not give any clinical manifestations for a long period. There are cases where rough foreign bodies of the nose and even objects with sharp corners did not cause patient complaints for a long time.

Over time, as a result of irritation and chronic injury to the mucous membrane of the nose by a foreign object, an inflammatory reaction may occur, leading to the appearance of clinical symptoms in the form of pain in the nose, mucous or mucopurulent discharge from one half of the nose. The swelling of the nasal mucosa resulting from inflammation causes difficulty in nasal breathing.

In other cases, a foreign body in the nose immediately, from the moment it enters the nose, causes various kinds of discomfort: tickling, irritation, feeling of a foreign object, pain in the affected half of the nose. Foreign body-related pain may radiate to the forehead, cheek, or pharynx.

The most intense pain syndrome is characteristic of a foreign body in the nose with sharp edges or protrusions. Such objects can cause significant damage to the internal tissues of the nose, resulting in nosebleeds. In some cases, a foreign body in the nose is accompanied by headaches and dizziness. Severe pain in the nose can lead to sleep disturbances, increased irritability, and in children - anxiety, tearfulness and frequent moodiness.

The classic symptom for a foreign body in the nose is a triad of symptoms: pain, nasal discharge and nasal congestion. A characteristic feature that distinguishes these symptoms from manifestations of rhinitis, allergic rhinitis and sinusitis is their one-sided nature. In children, most often a foreign body in the nose is accompanied only by a runny nose with discharge coming from only one half of the nose. In some cases, when taking a deep breath, a foreign body in the nose may migrate to the pharynx or larynx. Then in the clinical picture symptoms of a foreign body of the pharynx or a foreign body of the larynx appear.

Individual foreign bodies in the nose undergo some changes when they remain in it for a long time. Thus, peas and beans begin to increase in size from the moist environment of the nose, often completely blocking the nasal breathing of the half of the nose in which they are located. Some nasal foreign bodies will break apart, soften, or completely disintegrate over time. If the foreign body of the nose retains its original appearance, then it can become the core of a nasal stone, formed by the deposition of salts contained in the secretion of the nasal mucosa. With a long-term presence of a foreign body in the nose, the development of granulation tissue is possible, the growth of which is provoked by constant trauma to the mucous membrane. Developed granulations often hide a foreign body in the nose, making it difficult to visualize and diagnose.

Complications

Difficulty in nasal breathing and impaired ventilation caused by a foreign body in the nose can lead to inflammatory changes in the paranasal sinuses. If a foreign body remains in the nose for a long time, ulceration of the mucous membrane, the development of polypous growths, necrosis of the nasal concha, suppuration of the lacrimal sac, and disorders of the lacrimal ducts are possible. The addition of a secondary infection causes the development of purulent rhinosinusitis, and very rarely - osteomyelitis of the bone structures of the nose. In severe cases, a foreign body in the nose can perforate its wall.

Diagnostics

In most cases, a nasal foreign body can be diagnosed by an otolaryngologist based on medical history, examination of the nasal cavity and rhinoscopy. Difficulties in diagnosis arise in young children, whose medical history may not indicate a foreign object entering the nose. A long-existing foreign body in the nose is difficult to detect. During rhinoscopy, it may not be visualized due to severe edema, inflammatory changes in the mucosa, or formed granulations. In such cases, palpation with a metal probe is used to detect a foreign body in the nose. However, this only detects dense foreign objects.

Additionally, in case of a foreign body in the nose, bacterial culture of nasal discharge, ultrasound, CT or radiography of the paranasal sinuses, CT or radiography of the skull, and pharyngoscopy are performed.

Removing a foreign body from the nose

Removal of a foreign body in the nose should be carried out as early as possible, before swelling and an inflammatory reaction have developed, making it difficult to remove. A foreign body in the nose that has recently entered the nose can be removed by simply blowing it out. The patient is asked to draw in more air, close his mouth, cover his healthy nostril with his finger and blow out the collected air forcefully. This method can only be used in older children and adults.

In adults, after a failed attempt to blow out a foreign body in the nose naturally, and in small children, endoscopic removal of the foreign body is performed. In adults, the procedure is performed using local anesthesia; in young children, general anesthesia may be required. In rare cases where endoscopic removal is unsuccessful, the foreign body is removed surgically.

If necessary, additionally apply rinsing of the nasal cavity with antiseptic solutions, instillation of vasoconstrictor drops into the nose, drainage and rinsing of the paranasal sinuses, and treatment of complications.

Getting a foreign object into the nasal passages quite often happens to both adults and children. The reason for this may be a banal accident or risky games and fun, and the variety of objects that can end up in the nose is amazing.

Foreign body in a child's nose

Most often, foreign objects get into a child’s nose due to the carelessness of adults. Leaving a baby with small objects and toys that are not appropriate for his age is very dangerous, as this can lead to undesirable consequences. Otolaryngologists distinguish the following classification of objects that most often have to be removed from the nasal passages:

• metal parts of toys and household items;
• objects of organic origin;
• food particles and vomit;
• insects.

Symptoms of foreign body penetration into the nasal cavity include:

• itching, painful and uncomfortable sensations in the nose;
• swelling of the nose, sinuses and inflammation of the lacrimal canal;
• nose bleed;
• headache;
• nasal voice;
• sneezing;
• difficulty in nasal breathing.

Foreign body in the nose of an adult

A foreign body in the nose of an adult, as a rule, gets there by accident. Unlike a child, an adult can objectively assess the situation and, if possible, help himself by removing the object from the nasal passage. To do this, just close the free nostril with your finger and, inhaling deeply through your mouth, try to push out the foreign object with a stream of air.

If it is not possible to remove the object using the blowing method, this means that the object was able to penetrate higher up the nasal passage and will no longer be possible to cope without the help of a specialist.

What to do if something gets into the nasal passage?

The first rule that should be followed when a foreign object gets into the nasal passage is to remain calm and try not to aggravate the situation. In this case, you should go to the hospital as soon as possible, where an otolaryngologist will examine the nasal passages and assess the situation.

Depending on what kind of object got into the nasal passage and how far it managed to penetrate, the doctor will establish and carry out a plan for further action. If the body was able to penetrate up the nasal passage, the doctor will most likely prescribe an x-ray, with the help of which he will accurately determine the location of the foreign object.

The X-ray examination method will be effective only if a metal object has entered the nose; any other object will simply not be visible on the X-ray.

Having assessed the situation, the doctor will determine how the foreign body will be removed and whether the patient needs anesthesia. If the victim is a child, and the object has moved upward along the nasal passage, then anesthesia will most likely be required.

In rare cases, the otolaryngologist performs a number of other activities:

• manipulations in several parts of the nasal passage in case of splitting of the object into several parts;
• treatment of the nasal mucosa with adrenaline to relieve swelling;
• examination of the nasal passage using a probe;
• surgical intervention.