Removal of nasal foreign bodies in the pediatric population

doi:10.1016/S0735-6757(97)90049-8

The American Journal of Emergency Medicine

Volume 15, Issue 1, January 1997, Pages 54-56

https://doi.org/10.1016/S0735-6757(97)90049-8 Get rights and content

Abstract

Nasal foreign bodies requiring removal occur commonly in young children. Different techniques of removal are needed depending on the type of nasal foreign body. A retrospective chart review of a 19-month period identified 60 pediatric patients with nasal foreign bodies evaluated in a pediatric emergency department. Twenty-four different types of foreign bodies were removed; beads, rocks and plastic toys were the most common. Numerous removal techniques were used; forceps and Foley catheter techniques were the most common. Most foreign bodies can be managed with simple equipment and without requiring otolaryngology consultation. Because of the many different nasal foreign bodies found, the physician should be skilled in numerous techniques of removal. Each one of these useful techniques is reviewed.

References (11)

S Backlin
Positive-pressure technique for nasal foreign body removal in children
Ann Emerg Med
(1995)
D Baker
Foreign bodies of the ears and nose in childhood
Pediatr Emerg Care
(1987)
V Nandapalan et al.
Removal of nasal foreign bodies with a Fogarty biliary balloon catheter
J Laryngol Otolaryngol
(1994)
HA Cohen et al.
Removal of nasal foreign bodies in children
Clin Pediatr
(1993)
J Santamaria et al.
Ear, nose, and throat

There are more references available in the full text version of this article.

Cited by (73)

Comparison of pediatric nasal foreign body removal by care setting: A systematic review and meta-analysis
2022, International Journal of Pediatric Otorhinolaryngology
Citation Excerpt :
A p value of <0.05 was considered to indicate a statistically significant difference for all statistical tests. In total, 21 studies with 7830 pediatric patients were included in the meta-analysis (Table 1) [1,2,4–6,8,14–29]. For USA-specific analyses, a total of four studies with 378 pediatric patients were assessed.
Intranasal foreign bodies: A 10-year analysis of a large cohort, in a tertiary medical center
2021, American Journal of Emergency Medicine
Nasal foreign bodies (NFB) are commonly seen in pediatric patients seeking medical attention in the emergency department (ED). We aim to describe the occurrence, clinical presentation and management, of these cases, and to assess various risk factors for complications.
A retrospective analysis of a computerized patient directory of 562 children admitted to the emergency department during a 10-year period, with NFB, in a tertiary pediatric hospital.
Upon admittance, most of the children (82%) were asymptomatic. Among the symptomatic children (18%), the primary symptoms were nasal discharge (10%), epistaxis (8%) and pain (4%). Younger children (under 4 years) were more likely to insert organic materials, compared to older children. Younger children were also admitted sooner to the emergency department and were more likely to present with nasal discharge. The overall complication rate was 5%. None of the children had aspirated the foreign body. Complications included infection (2%), necrosis (0.7%), septal perforation (0.5%), deep mucosal laceration (1.5%) and loss of foreign body (1.9%). Significantly higher rates of symptoms and complications were associated with button batteries. Increased risk for complications were observed according to type of foreign body, multiple attempts to remove it, posterior insertion and left-side insertion.
Nasal foreign bodies in children are common. Mostly, patients are asymptomatic, therefore a high index of suspicion is required, for quick diagnosis and safe removal, without complications.
Nasal foreign bodies in children in a pediatric hospital in Senegal: A three-year assessment
2017, Annales Francaises d'Oto-Rhino-Laryngologie et de Pathologie Cervico-Faciale
Les corps étrangers nasaux (CEN) sont un accident domestique fréquent chez les enfants. L’objectif de ce travail était de présenter les particularités des CEN chez les enfants dans un hôpital pédiatrique sénégalais et décrire notre attitude thérapeutique.
Étude rétrospective descriptive au service d’oto-rhino-laryngologie du Centre hospitalier national pour enfants de Diamniadio du 1^er janvier 2013 au 31 décembre 2015 incluant tous les enfants de moins de 15 ans reçus pour CEN. Les variables étudiées étaient l’âge, le sexe, la provenance, le motif de consultation, le délai de consultation, la nature du CEN, la méthode d’extraction et les complications.
Cinquante-huit CEN avaient été recensés. L’âge moyen était de 3 ans 4 mois. Parmi les patients, 93 % avaient moins de 5 ans. Il y avait une prédominance féminine (53,45 %), soit un sex-ratio de 0,87. Les CEN étaient localisés chez 43 patients (74,1 %) à droite. Le premier motif de consultation était la rhinorrhée purulente retrouvée chez 51,7 % ; parmi les patients, 17,24 % étaient amenés en consultation dans les 24 premières heures. La mousse était le premier CEN (29,3 %), suivie des graines (20,7 %). L’extraction a été réalisée en consultation chez 84,5 % et chez 15,5 % au bloc opératoire. La morbidité était de 22,41 %. Il s’agissait dans 17,24 % d’une épistaxis et dans 5,17 % d’une infection nasale.
Les CEN sont des accidents fréquents chez l’enfant de moins de 5 ans. Notre contexte est marqué par un retard à la consultation.
Nasal foreign bodies in children in a pediatric hospital in Senegal: A three-year assessment
2017, European Annals of Otorhinolaryngology, Head and Neck Diseases
Citation Excerpt :
Table 3 presents NFB types from several studies. In the literature, 70–92% of NFBs are inorganic [1,6,7,9,10]; in the present study, the rate was 63.8%: mainly foam rubber (29.3%). In France, in 1998, François et al. [6] reported a predominance of plastic objects (23.5%), while in 2008, Claudet et al. [9] found a predominance of beads (31.4%).
Nasal foreign bodies (NFB) constitute a common domestic accident in children. The objectives of the present study were to report the particularities of NFBs in children presenting at a pediatric hospital in Senegal, and to describe our therapeutic attitude.
A retrospective descriptive study included all under-15 year-olds presenting with NFB in the ENT department of the National Children's Hospital Center of Diamniadio, Senegal, between January 1, 2013 and December 31, 2015. Study variables comprised: age, gender, provenance, presenting symptoms, time to consultation, type of NFB, extraction method, and complications.
58 NFB cases were retrieved. Mean age was 3 years 4 months; 93% of patients were under 5 years old. There was female predominance of 53.45%: i.e., sex-ratio, 0.87. Location was in the right cavity in 43 patients (74.1%). The presenting symptom was purulent rhinorrhea in 51.7% of cases. Time to consultation was within 24 hours in 17.24% of cases. NFB type was firstly foam rubber (29.3%), followed by grain (20.7%). Extraction was performed in consultation in 84.5% of cases and in the operating room in 15.5%. Morbidity was 22.41%: 17.24% epistaxis and 5.17% nasal infection.
NFBs constitute a common domestic accident in under-5 year-olds. The rural Senegalese context shows delay in consultation.
The removal of shrapnel from deep tissue with a magnet: a novel approach
2017, American Journal of Emergency Medicine
Patterns of nasal foreign body in northeast Malaysia: A five-year experience
2015, European Annals of Otorhinolaryngology, Head and Neck Diseases
Citation Excerpt :
Foreign bodies in the nose are common in children [1,2] and are relatively easily removed in an outpatient department; if the foreign body is a battery or is impacted, however, special precautions have to be taken.
The aim of this study was to determine the common presentations and management outcomes in case of nasal foreign body.
A retrospective study was carried out over 5 years, from January 2008 to December 2012. The total number of patients was 43; maximum age was 9 years. Patient biodata, clinical presentation, type of foreign body and management outcome were obtained and analyzed from the medical records of the Universiti Sains Malaysia Hospital.
Of the total 43 patients, 60.5% were male and 39.5% female. The most frequent age at which nasal foreign bodies were found was 3 years (48.83%) and the least frequent age bracket was 7–9 years (2.33%). Most patients had foul smelling nasal discharge (34.88%) or were asymptomatic (34.88%); the least common presentation was nasal discomfort (2.33%). Seeds (23.26%) were the most common foreign body, followed by rubber and batteries (16.28%). In most cases (58.14%), the foreign body had been inserted into the right nostril; 39.53% were inserted into the left nostril, and 2.33% were bilateral. Foreign bodies were removed under general and local anesthesia in 53.49% and 41.86% of cases respectively; 4.65% were dislodged spontaneously.
Nasal foreign bodies are encountered daily in our routine clinical practice in the pediatric age group. General anesthesia is required in uncooperative agitated patients to avoid complications.

View all citing articles on Scopus

View full text

Brief reportRemoval of nasal foreign bodies in the pediatric population

Abstract

Ann Emerg Med

Foreign bodies of the ears and nose in childhood

Pediatr Emerg Care

Removal of nasal foreign bodies with a Fogarty biliary balloon catheter

J Laryngol Otolaryngol

Removal of nasal foreign bodies in children

Clin Pediatr

Ear, nose, and throat

Brief report
Removal of nasal foreign bodies in the pediatric population