As a child grows up, parents often face many difficulties. Foreign body in a child's nose 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.
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 is lowered into the pharyngeal region, 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.
Routes of entry of foreign objects into the nose
IN nasal cavity different bodies can enter 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.
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.
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:
If the object is in the nose for a long time, then there are other symptoms that cannot be ignored:
- 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 - rhinoliths.
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.
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.
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.
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.
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.
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 by blowing, surgical or endoscopic removal.
Most often, otolaryngologists diagnose foreign bodies in the nose in children. During play, a child 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.
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 enter 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 injuries to the adjacent facial structures. 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 diagnosing 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 that a foreign object has entered 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 aforementioned 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.
A foreign body appears in the nose for various reasons, most often preschool children encounter this problem, but this also happens in adults. A foreign object sometimes does not cause any symptoms, but it can also give serious complications, therefore it is important to apply for medical help and remove it. Let us consider in more detail how pathology manifests itself in different situations, and what features it has.
Where do they come from
Nasal foreign bodies are objects that have accidentally or intentionally entered the nostrils. Children themselves put small particles into the hole on their own, this happens out of curiosity. In adults, there is mainly accidental penetration of objects. They can get there for the following reasons:
- while playing with children;
- when swimming in open water;
- inhalation of air (it may contain dust, insects and other small particles);
- when eating;
- while vomiting.
Even people who carefully monitor personal hygiene and do not try to stuff any objects into their nostrils can find foreign bodies in the nose. A high probability of accidental penetration of small particles is observed when vomiting or eating. The penetration of food pieces occurs by throwing them through the choanal openings that connect the pharynx to the nose.
Provoking reasons
A foreign body sensation in the nostrils can occur for various reasons. Often, objects enter the nostrils by natural means - by inhalation of air or improper handling of various things. However, there are times when, during a surgical intervention, the doctor leaves cotton swabs, various instrument tips or other parts of the work equipment in the aisle. In this case, the pathology is of iatrogenic origin.
Serious injury can result in pieces of glass, stones, pieces of wood, and other objects entering the nostrils. Foreign bodies can be located along the entire inner surface of the nose.
If they got into it naturally, then it is most likely that the doctor will find them in the lower nasal passages, but there are cases when the object digs into the nasal septum or turbinate. It also happens that with the inhaled air, particles move into the nasopharynx.
Particle types
The presence of a foreign body in the nose is determined either by the patient himself or by the doctor. A variety of objects can enter the nostril. To make it easier to make a decision about how to remove them, all particles were divided into main groups:
There is also a separation of foreign bodies in relation to visibility on radiography. If an object can be visualized during examination, it is radiopaque. These are mainly small inorganic and solid organic objects.
If no changes are visible in the picture, then we can say that the body is non-radiopaque. Basically, food particles and living organisms, which tend to decompose in the nose, are not visible on the film.
How to recognize
If something gets into your nose and causes discomfort, you should immediately consult a doctor. However, the patient does not always notice how small particles penetrate into the nostrils, sometimes the situation does not give itself away at all, or the disorder is “disguised” as other diseases. In this case, you should pay attention to a number of concomitant symptoms that most often disturb the patient:
If these signs appear, then a foreign body trapped in the nose interferes with normal vital activity. Untimely access to a doctor can lead to the addition of secondary infections and a number of complications.
Symptoms of prolonged presence of foreign objects in the nose are:
- unpleasant smell from the nose (a consequence of the decomposition of organic or living foreign bodies);
- purulent discharge;
- inflammation and soreness of the mucous membrane;
- one-sided headache;
- the formation of rhinolitis;
- loss of appetite;
- sleep disturbance.
Possible complications and risks
You need to immediately remove the object that interferes with breathing and living normally. If you ignore this, serious health problems can arise. Late seeking medical help leads to the fact that foreign bodies cause such complications:
Bodies of organic origin can change their volume, size and even consistency if they are in the nasal passages for a long time. For example, beans or peas can grow under the influence of mucus, in which case there is a complete or partial disturbance of breathing in the affected nostril. Also, living organisms and plant particles can decompose or disintegrate.
The most dangerous thing is when rhinolith begins to form around a metal or inorganic object - a stone consisting of salts that contains mucus. Rhinolith can be smooth and rough, soft and hard, it constantly irritates the mucous membranes, which leads to chronic rhinitis.
Also, with prolonged presence of a foreign body in the nostril, the growth of granulation tissue occurs, which complicates the diagnosis and causes frequent bleeding.
Diagnostic features
The otolaryngologist (ENT) is engaged in identifying the problem. In some cases, rhinoscopy is enough to make a diagnosis - an examination using special instruments. If the object has moved to the lower section, then fibrorinoscopy is needed. In this case, the doctor must treat the nasal cavity with adrenaline to relieve the swelling that interferes with the normal examination of the affected nostril.
If the object cannot be seen, then it is probed with a special metal probe made of metal. However, the tool only helps to recognize solid bodies.
With the addition of concomitant infections and the impossibility of conducting a normal visual examination, such techniques as ultrasound diagnostics, fluoroscopy, computed tomography and magnetic resonance imaging are used. Be sure to take mucus from the patient.
Methods for removing objects from the nostrils
It is important for patients to remember that the earlier they come to the ENT for examination, the more chances they have to get rid of the foreign body quickly and painlessly. If you see a doctor in time, you can avoid the appearance of edema, inflammation and the growth of granulation tissue, which greatly complicates the removal of objects from the nostrils. Otolaryngologists use the following methods to retrieve bodies:
- Blowing. This is the easiest way to get rid of the foreign object. In order for the procedure to be successful, the patient must close his healthy nostril with his finger, draw in full lungs of air and exhale it with great force through the diseased nostril. Small and smooth objects simply "fly out" when performing such a manipulation, relief immediately comes, breathing resumes and discomfort disappears.
- Endoscopy. Endoscopic elimination is indicated for children and adults who have been unable to clear the problem with blowing. In this case, both local anesthesia and general anesthesia can be used. The body is taken out of the nasal passages using a blunt hook, the ENT picks up small particles with it and removes them.
- Surgical intervention. It is indicated only in the most difficult cases, it is performed under general anesthesia. If it is necessary to get rid of foreign objects around which rhinoliths have formed, the stones are immediately crushed, and only then they are taken out along with foreign bodies.
Mandatory during the elimination of objects are procedures such as disinfection of the mucous membrane, rinsing the nostrils, and the use of vasoconstrictor drops. Also, in some cases, lavage of the sinuses is required, the establishment of drainage. If a foreign body has caused the attachment of secondary infections, their treatment is also carried out.
Prohibitions and warnings
The patient should remember that the ingress of a foreign body into the nasal passage is a good reason to visit an otolaryngologist. It is forbidden to carry out any manipulations on your own, since you can only aggravate the situation. You can also not take such measures:
Compliance with basic safety rules will be a good prevention. Children should not be left alone with small objects, cereals and other particles that can theoretically be shoved into the nostril. They should also choose toys that do not contain small parts.
Adults should wear personal protective equipment if they know there is a high likelihood of introducing foreign bodies through inhalation. Take your food slowly to avoid throwing it into the airwaysdo not swim in dirty waters where organisms can easily enter the nose.
Let's sum up
A foreign body can enter the nostril in different ways. The disorder often does not show any signs, but it causes some unpleasant sensations, similar to the symptoms of an incipient cold.
If you find the first signals that indicate the presence of foreign objects in the nose, you should consult a doctor. It is important to remove the particles in time so that they do not cause complications.