As a child grows up, parents often face many difficulties. Foreign body in the nose of a child is not the greatest rarity, especially in children aged 2 to 7 years.
It can get there by accident, during the game, out of the interest of the baby and due to other influences of factors. The most important thing is to extract it as quickly as possible, which is not always possible to do on your own. In this case, an otolaryngologist will help, who can quickly and with minimal damage remove a foreign object.
Some cases of nasal vestibulitis secondary to foreign bodies may require parenteral antibiotic therapy, preferably with cephalexin associated with nasal lavage saline... Foreign bodies in the nasal cavities are more common in accidents in children under 4 years of age, and in most cases they can be avoided with some parental care. The most common foreign bodies were foam fragments, small plastic artifacts, and legumes.
Although in most situations, relatively easy resolution, complications such as epistaxis and vestibulitis can occur. It is worth noting that although we did not observe a single case in this study, every foreign organ in the nasal fossa was aspirated and therefore a potential bronchial foreign body.
It is necessary to get rid of a foreign body from the nasal cavity as soon as possible due to possible complications. It is especially dangerous when the object falls into the pharyngeal area, causes severe inflammation or remains unnoticed for a long time. The presence of such a problem can be detected by various signs, sometimes children themselves talk about what happened, especially when it causes severe discomfort.
The training of a resident of Ohotolaryngology in emergency services is fundamental, because, according to the experience of our ministry, the occurrence of complications is directly proportional to the lack of adequate experience and tools. For all otorhinolaryngologists and nursing assistants at Susa Municipal Hospital Agiar.
Call for the removal of nasal and pharyngeal foreign bodies in children. Sharif S. Roberts G. Phillips J. Transnasal enters the brain with trauma. Pediatric aerodric foreign injuries are complications associated with timely diagnosis.
Routes of entry of foreign objects into the nose
AT nasal cavity different bodies can get there in different ways, knowing this is important when trying to retrieve it. Foreign objects enter the child's nose in the following ways:
- insects and various midges usually get in naturally, which can occur during a normal walk, as well as dust and other bodies from the environment;
- violent - the most common way, when the child himself puts various objects into the nasal cavity, it can also happen as a result of injury;
- iatrogenic pathway - this is the consequences of medical intervention, when cotton swabs or various instruments, or rather its tips, remain in the nose;
- choanal openings are also the cause of this problem when the child chokes or, during vomiting, food particles can enter the nasal cavity.
In addition, foreign objects are divided into different types. Depending on this classification, various complications are possible; shape, size and material are also of great importance.
Otolaryngology. 6th edition. Guanabara Kyogan; R. 92. Contract of otorhinolaryngology. 3rd edition. Sao Paulo: Rock Editor; R. 274. Treatment of otolaryngological foreign bodies. Ear foreign body removal: a review of 98 consecutive cases. The foreign body of the auditory tube. Annals of the 12th Meeting of the Brazilian Society of Otology.
Strange Nasal Organs Ear pharynx and paranasal sinuses. Positive pressure technique for removing nasal foreign body in children. Foreign bodies animated in otorhinolaryngology. Miasis in humans and animals in the neotropical region. Article adopted on June 16.
Highlighted:
- organic, for example, pieces of food, seeds of berries or fruits, various seeds;
- inorganic, such as buttons, toy parts, paper, polyethylene, beads, foam rubber, and so on;
- living bodies: midges, larvae, insects;
- metal objects such as coins, nails, screws, etc.
Also, foreign bodies are divided into non-contrast and X-ray sensitive. The latter type of objects allows using X-ray to determine the size and shape of the object, thereby the safest to remove it. In some cases, the parents themselves manage to easily eliminate the foreign body; it is also possible for its independent exit from the nasal passages, especially if it is round and small or soft.
Cavities are hollow air cavities filled within the bones of the skull. There are four parities of cavities and they are located behind the forehead, under the cheekbones, behind the eyes, and on either side of the bridge of the nose. The cavities are lined with mucous membrane and function to moisturize and warm the inhaled air before they can reach the lungs. The membranes in the cavities contain tiny hairs called eyelashes. They move to allow air and mucus to move within cavities and to help remove foreign objects or microorganisms.
The cavities usually produce mucus, which is drained into the nasal cavity through small channels. These channels also allow air inhaled through the nose to circulate freely in and out of the cavities. 1-7. Sinusitis refers to inflammation and infection of the lining of these cavities. The infection can be caused by a virus, bacteria, or even fungi.
But you can't hesitate with professional help, as it is very dangerous for the child. A foreign object can injure the mucous membrane, cause severe inflammation and other complications.
Various symptoms may occur if there is a foreign object in the nasal cavity. At the initial stage, they may not attract the attention of parents, which is a problem in diagnosing the disease. If the baby has the following symptoms, it is necessary to check the nasal passages even for prevention:
The inflammation causes swollen mucous membranes and also clogs the ducts that drain mucus from inside the cavities. This causes fluid build-up and results in pain symptoms over the cavities. The cavities behind the painter are most often affected. People who get sinusitis may have medical problems with the eyelashes that line the cavities, such as those with cystic fibrosis. In addition, colds and even allergies lead to the production of extra mucus and they block the opening of cavities.
Those with anatomical defects like a septum away, rectal nasal bone or tooth formation of nasal polyps also carries out blockages of the channels in the cavity that predispose to developing sinusitis. Smokers, those with large adenoids, dental infections, those who travel at high altitudes or diving may also be at risk of sinusitis.
If the object is in the nose for a long time, then there are other symptoms that cannot be ignored:
Who Affects Sinusitis?
Sinusitis is more common in adults. This rarely occurs in children under the age of five. Acute sinusitis is a very common disease that affects about 15% of the population in western countries.
What are the symptoms of sinusitis
There may be typical symptoms of fever, pain and tenderness on the face, especially in cavities. There may also be a blocked or exhausted nose. There is bad breath if there is pus inside the cavities. There may be a cough that usually gets worse at night. Headache, sore throat and mucus dripping down the back of the throat are other symptoms.- the presence of purulent discharge of a yellow or greenish tint;
- unpleasant odor from the nasal cavity;
- inflammation and redness of the mucous membrane;
- formation of stones - rhinolitis.
If these symptoms appear, you should immediately consult a doctor. With the skill, you can provide first aid to the child, but only if there is confidence that the situation will not worsen.
Sinusitis can be acute, secondary acute, or chronic. Acute sinusitis develops rapidly within a few days after a cold or flu and never lasts more than 4 weeks. Those with an acute secondary condition can have symptoms lasting 4 to 12 weeks. If symptoms persist for more than 3 months, the sinusitis will be chronic. Chronic sinusitis is less common and can last for months or even years.
This is usually done by doctors who specialize in ear, nose and neck problems. Clinical characteristics are used to identify sinusitis. In addition, anatomical defects such as the distal nasal septum, nasal polyps or straight teeth of the nasal bone are looked for, while these may predispose to sinusitis recurrence.
Problem diagnosis and extraction methods
To determine this problem, the doctor needs to conduct an examination and questioning. When the child is very small and cannot describe his feelings, the doctor has a harder time. Rhinoscopy is also often performed, fibrorinoscopy may be required if the object is in the lower part of the nasal cavity.
A light shines in the cavity to look for signs of inflammation. Regular X-rays can reveal whitish mucus buildup in the affected cavities. More advanced techniques include using a nasal endoscope or a thin tube with light and a camera at the tip. An inner tube is inserted into the nose and cavities to see the insides and detect infection and inflammation.
In most cases, when using contraceptives and decongestants available at pharmacies, can be used to relieve pain, nose and clogged cavities. A warm compress over the cavities, steam inhalation, nasal saline sprays, using a humidifier, or a neti pot to straighten the cavities are other self-reliance aids for sinusitis.
When these methods do not bring results, the examination is carried out using a metal probe, which "feels" the nasal cavity. In addition, doctors use X-rays, tomography of the relevant departments, ultrasound or contrast fluid, if necessary. Most often, the latest research methods are resorted to in situations with children under one year old, who not only cannot describe their feelings, but also do not allow a calm examination.
Antibiotics are only prescribed if the infection is found to be bacterial or the sinusitis has become persistent or chronic. Corticosteroid nasal sprays and antiseptics may be prescribed to reduce swelling, especially if you have nasal polyps or allergies.
Surgery to clean and drain the cavities may also be necessary. Fungal sinusitis usually requires surgery. In almost two-thirds of individuals, sinusitis does not require therapy and does not specify itself. Typical clearing time is about two to three weeks.
Usually the foreign body is removed with a blunt metal hook. In some cases, surgery may be required. Especially if the object has been in the nasal cavity for a long time and granulation has already formed. Even if the parents manage to remove a foreign object on their own, it is imperative to contact a specialist for examination.
Sneezing is a common and common symptom in children. However, when sneezing is repeated, it causes discomfort, which could be an allergy warning or viral infection... An unpredictable and unintentional, audible or unobtrusive sneeze is an exhalation of air through the nose and mouth caused by sudden movement of the expiratory muscles, including the diaphragm and intercostal muscles. It starts with a broad inspiration that the child controls, then air is forced through the nose.
This defensive reflex usually responds to irritation of the nasal mucous membranes or the presence of a foreign body. The nose drives out irritating agents or germs that can cause infection. As long as the intruders are not hunting, the sneezing continues. The nose runs, the eyes tingle, then the child is tired of such inappropriate sneezing that he has problems with control.
What is strictly forbidden to do
At home, you can provide the baby with first aid, but you need to know exactly what you can do, and what manipulations are strictly prohibited. Under no circumstances should you do the following:
- it is forbidden to try to remove the object with your fingers, tweezers, cotton swabs and other sharp and long objects, in most cases this leads to a deeper penetration of the body;
- do not instill drops in the nose, use sprays and rinse with water;
- do not press the nasal passage in which the object is located with your finger;
- you can not feed or water the child until the problem is eliminated;
- it is forbidden to carry out any manipulations at all before the arrival of the ambulance, if the object is not visualized.
First aid
First aid for a baby in such a situation includes the following actions.
Repetitive sneezing and allergies: be careful!
We must learn to distinguish between the punctual sneezing that any child can have at the moment, from the one whose cause may be a symptom of a suspected allergy. It is one of the main causes of repeated sneezing. More or less poisonous, it is very common between the February and October months and greatly interferes with a small child. He sneezes constantly, his nose runs through, his eyes are watery, his throat hurts. If they persist, these symptoms can affect their quality of life. His sleep is of less good quality, he is tired and more irritable as the days go by.
A nasal foreign body is a foreign object that accidentally got into the nasal cavity - a berry seed, bead, seed, mosquito or other insect, a small part of a toy, a piece of plastic, wood, food, paper or cotton wool. The presence of a foreign body in the nose can be asymptomatic. Basically, this is manifested by pain, discharge from the affected half of the nose and one-sided congestion. Diagnosis of a nasal foreign body is based on anamnesis, rhinoscopy, otolaryngological examination, radiography and CT data. The essence of the treatment of a foreign body of the nose is reduced to the fastest possible elimination of it by blowing, surgical or endoscopic removal.
The doctor will prescribe suitable treatmentessential for your baby's well-being. Repeated sneezing can also be associated with rhinopharyngitis. In this case, the cause is contagious, caused by a virus, and they will disappear spontaneously in a few days. In young children, a foreign body in the nose can also easily go unnoticed and cause sneezing. If a purulent nasal discharge occurs, accompanied by bleeding, babies must immediately be presented to the doctor so that the latter pulls out the foreign body.
Repeated sneezing: what solutions?
In so-called “normal” circumstances, there is no need to stop your child from sneezing. It is a healthy defense reflex that clears your nose to prevent impurities from entering your lungs. On the other hand, if these sneezes are repeated and persistent, it is possible that their cause is not natural. To make sure your child is free of allergies, including allergic rhinitis, talk to your doctor. He will refer you to an allergist, if he deems it necessary, that appropriate tests be done to determine the source of his allergy.
Most often, otolaryngologists diagnose foreign bodies in the nose in children. A child during games can deliberately introduce a different object into his nose, without thinking about the consequences. Foreign bodies thus trapped in the nasal cavity are, as a rule, in the lower nasal passage. Among the total number of foreign bodies in the nose, such cases account for 80%. Much less common are foreign objects in which one half is stuck in the nasal septum and the other in the inferior turbinate. Foreign bodies accidentally trapped in the nose are often localized very deeply.
If your baby regularly suffers from allergic rhinitis or nasopharyngitis, it may be an effective solution to reduce the number of annual episodes of nasopharynx and reduce symptoms. allergic rhinitisthus ensuring a better quality of life for your child.
Hearing impairment
A communication disorder can include auditory function, voice, language, or all three. More than 10% of children suffer from communication problems, but there are several types. More than 6% of schoolchildren suffer from vocal problems such as dysphonia. Such problems can affect the performance and socialization of the school at school and are usually caused by overuse or misuse of the voice. Small nodules may form on the vocal cords.
Classification of foreign bodies of the nose
Foreign bodies in the nose are extremely diverse in size, shape and character. So, foreign bodies of the nasal cavity are classified into:
- metal (screws, coins, metal constructor parts, nails, needles, fragments of firearms, buttons);
- inorganic (beads, plastic parts, pebbles, beads, pieces of glass, cotton wool);
- live (larvae, insects, roundworms, leeches);
- organic (peas, seeds of various plants, parts of foods used in food, small beans, fruit seeds, pieces of vegetables and fruits).
Also, foreign bodies of the nose are divided into radiopaque and radiopaque, depending on whether they are visualized during an X-ray examination or not. X-ray contrast bodies are glass, metal objects, bones, parts of toys, buttons.
Complications of a foreign body of the nose
Foreign bodies in the nose lead to the appearance of obstructed nasal breathing and ventilation disorders, which further provokes inflammatory changes in the paranasal sinuses. Prolonged stay of a foreign body in the nose can cause ulceration of the mucous membrane, necrosis of the turbinate, the development of polyposis growths, disorders of the lacrimal ducts, and suppuration of the lacrimal sac.
In turn, the addition of a secondary infection provokes the development of purulent rhinosinusitis, in some cases of osteomyelitis of the nasal bone structures. In addition, there are severe cases when a foreign body of the nose begins to perforate its wall. That is why, at the first symptoms of a foreign body in the nose, you should immediately consult a specialist.
Pathogenesis of a foreign body of the nose
A foreign object can enter the nose naturally from the environment. Thus, the object can enter from the pharynx through the choanal openings and through the nostrils. As a rule, foreign bodies that have entered the nose through the nostrils are found in preschool children. It is at this age that children, for the sake of interest, can put various objects in their noses. Also, living organisms that are in the inhaled air or in water from reservoirs and open sources can accidentally get into the nose.
Foreign bodies of the nose of an iatrogenic nature are not very common. These objects represent a cotton swab left in the nose, part of a surgical instrument that was used during operations (resection of the turbinate, correction, septoplasty, removal of a tumor of the nasal cavity, etc.) or various otolaryngological procedures.
Choking while eating or vomiting can cause foreign bodies to enter the nose. At such moments, pieces of food and other objects that were in the pharyngeal cavity enter the nose through the choanal openings, thanks to which the pharynx is connected to the nose. Also, the ingress of a foreign body into the nose can occur when the nose is injured or various damage to the structures of the face adjacent to it. In this case, a piece of wood, a shard of glass, a bullet or loose bone fragment, a sharp object can become a foreign body of the nose.
Symptoms of a foreign body in the nose
The ingress of a foreign object into the nasal cavity can be accompanied by reflex sneezing, lacrimation and watery discharge from one side of the nose. True, such symptoms disappear very quickly, after which the patient will not feel anything. For example, small foreign bodies in the nose, which have a smooth surface, can leak for a long time without clinical manifestations... There are cases when even objects with sharp angles and rough foreign bodies of the nose did not cause complaints in the patient, and for a long time.
Under the influence of a foreign object of the nose, the mucous membrane is injured, which provokes a strong inflammatory process, which is accompanied by such clinical symptoms as pain in the nose and mucous or mucopurulent discharge from one half of the nose. As a result of inflammation, swelling of the nasal mucosa occurs, which makes nasal breathing difficult.
A foreign body in the sinuses in other cases immediately after getting into the nose causes various kinds of discomfort:
- feeling of a foreign object;
- irritation;
- tickling;
- pain in the affected side of the nose.
Pain associated with a foreign body may radiate to the forehead, throat, or cheek. The most pronounced pain syndrome is with foreign bodies with sharp angles, it can be any metal object. Such objects very much damage the inner tissues of the nose, often provoking the appearance. A foreign body in the nose is sometimes accompanied by dizziness and headaches. In the future, the pain intensifies, leads to increased irritability, sleep disturbance, in children - to anxiety, frequent whims and tearfulness.
For a foreign body in the nose, the classic triad of symptoms is pain, discharge and nasal congestion. These symptoms have a bilateral nature, which distinguishes them from manifestations, and. A foreign body in the nose in children is most often accompanied only by a runny nose with discharge that comes from one half of the nose. With a deep breath, in some cases, a foreign body of the nose can migrate into the pharynx or larynx, which is accompanied by an increase in pain and the appearance of a number of new symptoms.
Some foreign bodies of the nose, which are in it for a long time, undergo some changes. For example, beans and peas from a moist nasal environment significantly increase in size, which leads to blockage of nasal breathing, but only in the part of the nose where they are localized. Some foreign bodies can eventually break apart and even disintegrate completely. In the case when the foreign body of the nose did not dissolve and left its original appearance, in the future it can become the nucleus of the nasal stone. It is worth noting that it is formed with salt deposits that are contained in the secretion of the nasal mucosa. If a foreign body stays in the nasal cavity for a long time, this will increase the risk of developing granulation tissue, its growth provokes permanent mucosal injury. The granulation tissue will obscure the nasal foreign body, making it difficult to visualize during diagnosis.
Diagnostics of the foreign body of the nose
The otolaryngologist is responsible for the diagnosis of a foreign body of the pharynx based on the history, rhinoscopy results and examination of the nasal cavity. Much more problems arise with the diagnosis of foreign bodies in the nose in children. younger age... Very often, there is no indication of a foreign object entering the nose in their history.
It is also difficult to diagnose a foreign body that has been in the nasal cavity for a long time. The fact is that due to pronounced edema, formed granulations or inflammatory changes in the mucous membrane, it may not be visualized during rhinoscopy. To detect a foreign body in the nose in such situations, a metal probe is used. However, with this method, only dense foreign bodies can be detected.
In case of a foreign body of the nose, an ultrasound scan, bacterial culture of discharge from the nose, CT or X-ray of the paranasal sinuses, pharyngoscopy, CT or X-ray of the skull are additionally performed.
Treatment of a foreign body of the nose
The foreign body of the nose has a number of dangers, therefore, its removal should be carried out as quickly as possible so that the inflammatory reaction and swelling do not develop. Otherwise, the extraction process will become much more difficult. If a foreign body has just entered the nose, it can be removed by simple blowing. The patient should take in air, close his mouth and forcefully blow out the collected air, while covering the healthy nostril with his finger. This method is only suitable for adults and older children.
If adults and young children have not been able to remove the foreign body naturally, endoscopic removal is necessary. In young children, the procedure is performed under general anesthesia; for adults, local anesthesia is sufficient for this. A foreign body is removed surgically very rarely, only in cases where endoscopic removal has not been successful.
In addition to the above methods, rinsing of the nasal cavity with antiseptic solutions, drainage and rinsing of the paranasal sinuses, instillation of vasoconstrictor drops into the nose are additionally used. If necessary, treat complications.