Subject: ENT Topic: Foreign Bodies in Nose

1. Foreign bodies in the nose.
Grp 12
Devika Bhavsar

2. WHAT IS FOREIGN BODY?
An object is considered a "foreign body" if the object is in a location in the body
where it does not belong
Commonly encountered in emergency department
• In children (2-4years)
• Seen in adults who are mentally retarder or psychiatric illness
• Foreign body nose harbors potential for mortality if the object is dislodged into
airway

3. What are the clinical features of nasal foreign body?
Patients usually present with foul-smelling purulent nasal discharge that is usually
unilateral. NFBs are usually painless, however, some children present with
headaches on the same side of the foreign body. Moreover, bloody stained
discharge or even epistasis might be witnessed in these cases.

4. FREQUENTLY ENCOUNTERED FOREIGN BODIES:
• Pebbles
•Slate pencils
• Beads
• marbles
• peas
• Beans
• nuts
• button batteries
• paper wads

5. Foreign bodies in the nose
Inanimale
• Vegetable:
Pea, maize, gram, bean, nut
• Non vegetable:
Paper, cotton wool, pencil, eraser, chalk
• Mineral Fart o metal oasic or washer. pebble, nail
metal screw, button, sponge, disc battery
Animate
Leech, maggot, insect.

6. BUTTON BATTERIES:
result in severe destruction of the nasal septum.
• These are composed of various types of heavy metals: mercury, zinc, silver,
nickel, cadmium, and lithium. Liberation of these substances causes various types
of lesions depending on the localisation,
• it causes intense local tissue reaction and liquefaction necrosis.
• As a result they can cause septal perforations, synechiae, constriction, and
stenosis of the nasal cavity.

8. CONSEQUENCES:
Inert Foreign body
Infection and inflammation of mucous membrane
Granulation tissue formation and ulceration of mucosa
Necrosis of bone or cartilage
Vegetable foreign body
Absorb water and swell
evoke brisk inflammatory response

9. SYMPTOMS:
• Unilateral fetid discharge: mucopurulent or blood stained
• u/I nasal obstruction
• Pain
• Nasal bleed
• Excoriation of nasal vestibular skin

10. Removal of a foreign body from the nose.
Close the mouth and the other nostril and let the patient blow the nose or sneeze.
• Try to remove the object with a paper clip bent to form a 'spoon'.
• Try to remove it with a 'crocodile' forceps.
Connect a piece of rubber tubing to a suction and try to suck out the object.
• NB: Take care not to push the object in deeper, causing it to go down the throat
and be aspirated!!!

11. REMOVAL OF FB UNDER GENERAL
ANAESTHESIA
•Patient is anesthetised with cuffed ET tube.
Pharyngeal pack placed
if foreign body is placed posteriorly, patient boy positioned in rose position and
mouth gag applied.
Palate is generally retracted with a catheter which is placed through unaffected
nasal cavity.
Foreign body is post from another anterior into the names of airings and pick up
with forceps.

12. REMOVAL OF RHINOLITH:
Done under general anaesthesia.
It is removed in this peacemeal .
It is very large- It is removed by lateral rhinotomy

13. INANIMATE FB REMOVAL:
Child is restrained in upright position.
Add a few drops of nasal decongestant.
Proper sectioning to visualise foreign body curved hook is passed beyond foreign
body and gradually drawn forward and removed completely