Foreign bodies in the nose. Foreign body in a child’s nose: signs, tips for assistance

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.

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 total number 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 of a foreign body in the nose

Foreign body entry into the nose can occur naturally from environment through the nostrils and from the pharynx through the choanal openings. Nasal foreign bodies that enter through the nostrils occur mainly in children preschool age who, for the sake of interest, put various small objects into their noses. Living organisms in the inhaled air or water from the air can accidentally enter the nose. open sources and reservoirs. 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 construction set, needles, nails, buttons, fragments of firearms), organic (seeds various plants, peas, small beans, pieces of vegetables and fruits, fruit seeds, parts of foods eaten), 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 known 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 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. Characteristic feature What 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. So, peas and beans from humid environment The nose begins to increase in size, 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 of a foreign body in the nose

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.

Diagnosis of a foreign body in the nose

In most cases, a nasal foreign body can be diagnosed by an otolaryngologist based on medical history, examination of the nasal cavity and rhinoscopy. Diagnostic difficulties arise in children younger age, in whose anamnesis there may be no indication of 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.

Treatment of a foreign body in 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 failed attempt blowing 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.

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The doctor often encounters foreign bodies in the nasal cavity, but there is no general data on this issue; The literature describes only isolated cases without emphasis on physician errors. Foreign bodies in the nasal cavity occur mainly in young children, which is why errors occur more often among pediatric otorhinolaryngologists.

Foreign bodies enter the nasal cavity most often through the right half; you need to look for them primarily in the lower nasal passage, less often in the middle, and even less often in the upper. Sometimes, due to the carelessness of the doctor, foreign bodies end up in the nasal cavity after surgical procedures (pieces of cotton wool, tampons, fragments of surgical instruments).

Through the choanae, foreign bodies can enter the nasal cavity during vomiting (more often this occurs with paralysis of the soft palate, various congenital anomalies development of the palate). Foreign bodies can enter the nasal cavity due to injury, when the integrity of the nasal walls is damaged, although in children this route is extremely rare.

Ways of foreign bodies entering the nasal cavity:

Injected into the nasal cavity by the victim himself
Inserted into the nasal cavity by someone else’s hand (during a game, during medical procedures)
Accidentally entering the nasal cavity (through the entrance to the nose, through the choanae)
Trapped in the nasal cavity due to trauma

Foreign bodies in the nasal cavity can be a variety of objects: coins, pieces of cotton wool or paper, pencil lead, fruit seeds, beads, small parts from toys, etc.

To avoid mistakes, it should be remembered that in the nasal cavity there may be teeth (incisors and canines), which grow there from tooth germs as a result of their inversion (heterotopia).

If there is a foreign body in the nasal cavity (more often this is a unilateral process), difficulty in nasal breathing through the corresponding half of the nose and purulent discharge from it are noted. Sharp foreign bodies can damage the mucous membrane, which is accompanied by nosebleeds. When a foreign body is located in the middle nasal passage, loss of smell and lacrimation are observed due to blockage of the excretory duct of the nasolacrimal canal. Prolonged stay of a foreign body in the nasal cavity can lead to the development of an inflammatory process in the paranasal sinuses, which will require adequate therapy.

In young children, a reliable sign of a foreign body in the nasal cavity is an unpleasant odor and purulent discharge from the affected half of the nose. In some cases, diagnosis presents significant difficulties and can be erroneous, since granulations develop in the nasal cavity, which mask the presence of a foreign body. Feeling with a metal probe helps to avoid mistakes in diagnosing foreign bodies.

Contrast foreign bodies can be detected by radiography and computed tomography. With overgrown granulations, in order to avoid mistakes, it is necessary to differentiate them from malignant tumors nasal cavity.

Treatment consists of removing the foreign body. In the past, doctors widely used gentle, non-instrumental removal methods. The simplest of them is strong nose blowing, but this method is applicable only to older children. For young children, air was blown into the mouth or through the free half of the nose according to the Politzer method.

The most reliable way to remove a foreign body is instrumental, but it is the most dangerous. Preliminary anemization and anesthesia of the nasal mucosa are performed. Round foreign bodies are removed with a special probe with a curved end. The hook is inserted from above behind the foreign body and removed from back to front. Flat foreign bodies are easier to remove with nasal forceps. Wedged foreign bodies large sizes must first be crushed and extracted in parts. Inflammatory phenomena caused by the presence of a foreign body are quickly eliminated after its removal. However, with prolonged pressure of a foreign body on the bone, osteomyelitis develops.

To prevent foreign bodies, it is necessary to exclude small objects from the everyday life of young children. Parents and older children need to be educated about the dangers of foreign bodies getting into the nasal cavity. Special attention necessary to prevent the appearance of foreign bodies during operations in the nose, which, of course, is a gross mistake, with subsequent legal proceedings.

Rhinoliths

Only some authors consider rhinoliths (nasal stones) to be foreign bodies. Rhinoliths are formed as a result of the deposition of salts from the secretion of the mucous membrane of the nasal cavity and lacrimal glands around a foreign body that has been in the nasal cavity for a long time.

The formation of rhinoliths is facilitated by changes in the nasal cavity (deviation of the nasal septum, hypertrophy of the nasal turbinates), causing a delay in the secretion of the mucous membrane. Rhinoliths can be of various shapes: oval, round, plate-shaped. Sometimes they are a cast of the nasal cavity. Most often, rhinolitas are single, but they can also be multiple, so in order to avoid mistakes, you need to carefully examine the entire nasal cavity to the choanae.

The leading symptoms are unilateral difficulty in nasal breathing and purulent discharge from the corresponding half of the nose. Granulations can grow luxuriantly around the rhinolith. Sometimes general phenomena are observed: headache, bad dream. Differential diagnosis must be carried out with osteomas and simple foreign bodies.

Treatment consists of instrumental removal of the rhinolith, or, if it is large in size, surgical removal.

Live foreign bodies in the nose

Live foreign bodies in the nasal cavity may include worms (pinworms, roundworms, leeches), and insect larvae. Roundworms enter the upper respiratory tract from digestive tract when vomiting or crawl in there on their own. At the same time, children complain of headaches and discomfort in the nose. When moving and manipulating, roundworms can enter the sinuses, larynx, trachea and cause asphyxia, fatal outcome. Ascaris is removed from the nasal cavity using tweezers.

Pinworms that have entered the nasal cavity from the stomach are destroyed by lubricating the nasal mucosa with menthol oil, and then removed with tweezers.

When drinking water from stagnant bodies of water, leeches can enter the nasopharynx and crawl from it into the nasal cavity, which is accompanied by bleeding, difficulty in nasal breathing, and itching. The leech is removed by grasping it with tweezers.

In addition, fly larvae can enter the nasal cavity, which, using a suction apparatus, attach to the mucous membrane and cause its destruction (as well as the periosteum and underlying bone); When manipulating, special care is required due to the possibility of penetration into the orbit and brain.

Children complain of headaches in the frontal and parietal areas. Some people experience dizziness, which sometimes leads to diagnostic errors. Copious mucus with ichor appears from the nose and unpleasant smell(a tumor must be excluded). When the larvae move, irritation of the nasal mucosa occurs, so children often sneeze, and this can lead to diagnostic errors.

The diagnosis is made using anterior rhinoscopy, in which white moving larvae are identified on the mucous membrane. To clarify the diagnosis, the use of optics is necessary. Then the nasal mucosa is anemized and the larvae are removed with nasal tweezers.

Symptoms of foreign bodies in the nose

Summarizing the above once again, let us note the features of foreign bodies in the nose. Objects with sharp edges usually cause nasal pain and bleeding, foreign bodies that swell, make breathing difficult and lead to inflammation with purulent discharge. Small foreign bodies with a smooth surface long time may be in the nose asymptomatically, sometimes they enter the nasopharynx, larynx, trachea and bronchi. If a foreign body lingers in the nose for a long time, it causes long-term rhinitis and the appearance of granulations. Inorganic salts (calcareous and phosphorus) are deposited on and around it, making it look like stone (rhinolite).

To date, the etiology of rhinoliths remains unclear. Apparently, the cause of their formation is not always a foreign body.

Diagnosis of foreign bodies in the nose

In case of unilateral nasal congestion, purulent or sanguineous-purulent discharge from it with an unpleasant odor, anamnesis is ascertained, rhinoscopy is performed, palpation with a probe, etc. To reduce swelling, a 0.1% solution of adrenaline is used. A small foreign body with swelling and bleeding of the mucous membrane, when it is surrounded by lush granulations or is located in the posterior parts of the nasal cavity, is easier to find using optics. Metallic foreign bodies and so-called stray teeth are diagnosed using radiography and computed tomography (CT) of the nose.

Treatment of foreign bodies in the nose

A foreign body in the nose sometimes comes off spontaneously (when you sneeze), but usually it is removed instrumentally. In this case, it is necessary to prevent aspiration of a foreign body into the underlying parts of the respiratory tract. A small foreign body is removed with a blunt hook, which is inserted behind it. Extraction is carried out along the bottom of the nasal cavity in the direction from back to front. It is inappropriate (and in some cases dangerous) to remove a hard foreign body with tweezers.

You should not try to remove a foreign body by blowing air ("Politzer shower") or pouring water into the healthy part of the nose; for this you need so much high blood pressure that there is a danger of nasal discharge or douching fluid penetrating the auditory (Eustachian) tubes, as a result of which purulent inflammation of the middle ear will develop, and the foreign body will remain unremoved. Thus, the requirements that are mandatory when removing a foreign body from the external auditory canal are erroneous in this case. You should not try to remove a round-shaped body with a forceps or tweezers (the attempt will be unsuccessful; moreover, when the branches of the instrument are closed, the round-shaped body moves deeper).

Only flat buttons and similar shaped objects are removed with forceps-like instruments (they can be installed in the nasal passage like wheels on a car and squeezed with forceps on both sides). The same applies to soft objects - swollen peas, seeds, cotton balls, etc. To remove round objects, it is preferable to use a so-called ear spoon or a thick button-shaped probe, which can be easily bent into a curved shape. With the help of such an instrument, one goes around over the object, directing the curvature or depression of the spoon behind the object and removes it, lifting up the end of the probe or instrument in the hand and pushing out the foreign body with a strong movement from back to front. In this case, it is necessary to hold the child tightly. Lubricating the nasal entrance with a 10% solution of cocaine greatly facilitates the task, since, on the one hand, the child’s defensive movements are weakened, and on the other, the swollen anterior end of the inferior turbinate falls off due to the vasoconstrictor effect of cocaine.

If the first attempt is unsuccessful or if the foreign body is large, located deep in the nasal cavity or at the top of the middle nasal passage, in a word, if it is difficult to see and reach, the child should not be tormented by extraction. It causes him pain, causes bleeding and makes it very difficult for another, experienced specialist, whose intervention in this situation is necessary, to remove it.

If the attempt is successful, the free passage of the nose is restored, the increased and modified mucus secretion, swelling and cracks disappear after a few hours or days, without requiring further treatment.

Children's curiosity sometimes knows no bounds. During the game, accidentally or unconsciously, the little ones are able to insert a foreign body into their nasal passage - a bead, small detail favorite toy, berry seed or seed. In some cases, this condition may not be accompanied by unpleasant sensations at first and may not annoy the children. However, if the foreign body is not removed in time, complications are possible.

Cause and effect

Most of the young patients diagnosed with a foreign body in the nose are no older than 5–7 years. Most often, they come to the appointment after they experience pain, unilateral congestion and discharge from the affected nostril. After all the necessary manipulations to track the foreign body, the doctor decides to remove it. As a rule, the latter is located at this moment in the lower nasal passage, although medicine also knows cases when one part of the object was in the nasal septum, and the other in the inferior nasal concha.

Pay attention! Foreign bodies do not always enter the nose as a result of conscious actions. Sometimes they end up there as a result of injury, at the moment through the nasopharynx or after medical procedures, for example, when a child forgets to remove a tampon from his nose, which allowed him to stop the bleeding.

Conventionally, doctors divide all foreign bodies that enter the nasal passages according to the nature of their origin into:

living organisms - these include insects, larvae and even leeches;
organic – pieces of food, bones, seeds;
inorganic - buttons, beads, cotton swabs, paper, sponges;
metal - coins, pins, nails, needles.

Also in medical circles there is another classification based on sensitivity to x-rays. According to it, foreign bodies can be:

radiopaque, that is, noticeable on a regular photograph;
X-ray non-contrast - in order to see them in the picture, X-rays are taken with a contrast agent.

Foreign body in the nose: symptoms

The very first and a clear sign, indicating the presence of a foreign body in the nasal passage - one-sided nasal congestion.

In addition to it, the problem will also be indicated by:

Important! Doctors do not recommend removing a foreign body from the nose on your own, even if, at first glance, the process seems simple. Due to inept actions, objects can get into the nasal septum, inferior nasal concha, choanae, food or respiratory tract. Moreover, in this case the situation will probably worsen due to trauma to the mucous membranes.

Diagnostics

The presence of a foreign body in the nasal passages is confirmed in the otolaryngologist's office. As a rule, diagnosis begins with a history, although you cannot rely entirely on it in the case of young children. Parents may not notice the moment when the object ends up in the child’s nose, and the child himself may simply be afraid to tell his parents about it, and after a while, forget completely.

The next stage is rhinoscopy or fiberoscopy. They are effective if the foreign body is localized in the posterior sections. In this case, the mucous membranes are treated with adrenaline, which helps reduce swelling and allow the doctor access to examination. This procedure allows not only to identify the location of the foreign body, its size and nature, but also to suggest the route of entry, and, as a result, planning the extraction route.

At the discretion of the doctor, other diagnostic methods may be used:

the introduction of a metal probe for palpating the nasal passages using - it is indispensable in cases where the object was in the nose for too long, which resulted in severe swelling of the mucous membranes, the development of inflammation and granulation tissue;
sinuses;
bacterial culture;
with or without contrast agent.

Pay attention!It is necessary to go to the doctor immediately after you suspect the presence of foreign bodies in the nose. In advanced cases, granulation tissue appears at the site of the lesion, the purpose of which is to promote wound healing by secondary intention. As a result, the child will constantly experience pain at the location of the foreign body. In addition, the process of diagnosing the problem will be difficult as a result.

Removing a foreign body from the nose

An effective way getting rid of discomfort – quick removal foreign body from the nasal sinuses. It should be carried out as quickly as possible, since, firstly, children have narrowed nasal passages, which complicates the situation, and, secondly, they develop swelling and inflammatory processes more quickly.

Pay attention! If the foreign body stops close to the natural openings of the nose, you can try to remove it yourself by blowing it out. To do this, just take a deep breath through your mouth, and then, closing your healthy nostril and mouth, exhale through the affected nostril.

For older children, who can also judge whether the object has completely come out of the nose, blowing is usually sufficient.

If for some reason the situation has not changed after this, removal of the foreign object is carried out on an outpatient basis in several stages:

Blowing your nose– at this stage, a vasoconstrictor solution is instilled into the nose and after a few minutes the child is asked to blow his nose. As a rule, big bodies exit successfully in this case. If this does not happen, move on to the next stage.
Using a blunt hook. The manipulations are extremely simple: local anesthesia is applied, then a special hook is placed behind the foreign body and, with its help, it is pulled towards itself with sliding movements. If necessary, the procedure is repeated several times.
Surgical removal. It is resorted to if the body has embedded itself in the soft tissue, as a result of which the process of its removal is difficult. The operation is also justified if the object has a sharp end and can injure the mucous membranes.

If rhinolitis– nasal stone, all procedures are carried out under. First, using forceps, the rhinolite is crushed into small pieces, and then removed using a hook.

Important! Under no circumstances should round foreign bodies be removed with tweezers or forceps. At any second they can move into the nasopharynx or deep parts of the nose, respiratory tract.

The final stage of treatment is anti-inflammatory therapy. It applies even if the item was successfully removed at home. Within its framework, the patient is instilled into each nostril a drop of a solution made on the basis medicinal herbs. In severe cases, antibiotic drops are used.

Complications

Prolonged ignoring of the problem and, as a consequence, prolonged presence of a foreign body in the nose, can provoke expansion of the latter and blockage of the nasal passage. Most often they are diagnosed when peas, seeds, or paper are ingested. In this case, the child gradually begins to breathe through his mouth. But this is far from the worst thing.

It’s worse when the foreign body begins to crumble into small pieces directly in the nasal passages. Then its individual parts move when you sneeze or cough, ending up in different parts. The only way to save a small patient from the problem is to gradually remove them. This procedure is usually performed in a hospital setting.

Another unpleasant consequence - formation of rhinolith. This is a nasal stone, which appears due to the fouling of a foreign body with salts, which are in the secretion of the nasal mucosa.

Pay attention! Small objects in the nose are no less scary than large ones. They may not make themselves felt for a long time, after which they provoke the development of granulation tissue, pain and difficult diagnosis of the cause.

Prevention

You can prevent a foreign body from getting into your nose by following a series of simple rules which state that:

A foreign body in the nose is not the most serious condition, however, it requires care and precision. To avoid serious consequences and complications, only medical professionals should remove any objects from the nasal passages. If you contact them in a timely manner, the procedure usually takes only a few minutes.

Betsik Yulia, medical columnist

Any object that ends up in the nasal cavity for any reason is called a nasal foreign body. In young children, this situation occurs quite often, because the child likes to put a wide variety of objects into his nose. Sometimes children stick foreign bodies into a peer’s nose.

The risk of such a problem occurring is especially high when the baby begins to move independently and explore with curiosity the world around us. Small objects found that arouse interest can easily end up in the nose.

Types of foreign bodies in the nose

Babies are strictly forbidden to put any small objects in their hands - children often experiment by inserting these objects into their noses.

What kind of objects have not been removed from the noses of babies:

beads;
small parts of toys;
buttons;
cotton wool;
sponge pieces;
scraps of paper;
fruit grains;
sunflower seeds;
beans;
peas, etc.

Pieces food products can get into the nose if the baby chokes during feeding. In this case, food particles enter the nose through the choanae - openings connecting the nasal cavities with the pharynx. Vomit also enters the nose through the choanae. Teeth may be found in the nasal cavity due to improper eruption of canines or incisors. Foreign bodies can enter the nasal cavity when open.

Foreign bodies in the nose can be:

live (leeches, insects);
non-living - organic (plant seeds, pieces of fruits and vegetables) and inorganic (pebbles, foam rubber, paper, plastic parts of toys, etc.);
radiopaque (metal buttons, snaps, screws, etc.) and non-contrast.

Items may have different shapes and size.

Parents are not always able to track the moment a foreign body enters the nose and then do not know for even a long time about its presence in the nose. And sometimes the fact that a foreign object has entered the nose is detected immediately.

When foreign bodies remain in the nasal cavity for a long time, calcareous and phosphorus salts can be deposited in them, resulting in the formation of rhinoliths (nasal stones), sometimes of considerable size.

Symptoms

Immediately after a foreign object enters the nose, lacrimation and sneezing reflexively appear. But these manifestations disappear quickly enough due to the tissues becoming accustomed to the foreign body.

After about 3 days, the following symptoms occur:

one-sided;
discharge from one nasal passage of mucous discharge with an unpleasant putrefactive odor (an admixture may be noted);
unilateral headache;
difficulty breathing;
pain in the nose;
irritation of the skin at the nasal entrance.

If the foreign body is not removed, the inflammatory process spreads to the paranasal sinus and sinusitis develops. In rare severe cases, bone tissue melts (occurs). As granulation tissue grows, nosebleeds may occur.

Diagnostics

A pediatric ENT doctor is involved in the diagnosis and removal of a foreign body from the nasal cavity (). After interviewing the parents, he conducts an internal examination of the nasal cavity - rhinoscopy. If necessary, radiography, fibrorhinoscopy and examination with a probe using local anesthesia can be performed. In the case of the inorganic nature of the foreign body in the nose, a contrast agent is used.

During rhinoscopy, the doctor sees redness and swelling of the mucous membrane. When the mucosa is damaged by a sharp foreign body, proliferation of granulation tissue may occur, which requires differentiation of the formation (foreign body covered with granulations) from.

The inferior meatus is the most common location for a foreign body that becomes wedged between the nasal septum and the inferior concha. a foreign body may enter the middle nasal meatus.

First aid

The doctor will perform a rhinoscopy and, having found a foreign body, remove it using special tools.

If a child puts an object in his nose in the presence of his parents, then his nasal passages (nostrils) need to be examined. You shouldn't panic. If you manage to see a foreign body, it is better to contact an ENT doctor.

If this is not possible, you can start providing first aid:

It should be dropped into the nose. You should not use a spray, because the stream of medicine can push the foreign body deeper.
If the child is very small and is not able to follow commands, then you need to watch your breathing to find out in which nasal passage the air passes through with difficulty. Then you need to close the healthy nasal passage with your finger, pressing the nostril to the nasal septum, and exhale sharply into the baby’s mouth (trying to blow out the object), repeating the action several times.
If the child is older and understands the requirements, then you should ask him to breathe through his mouth. He needs to take a deep breath (while the parent pinches his healthy nostril) and then exhale forcefully through his nose. If the baby feels that the object in the nose is moving, then this procedure must be repeated until the body comes out.
If it was not possible to free the nostril, you can provoke the child to sneeze by letting him smell ground black pepper.
If these actions are unsuccessful, you should immediately contact a medical facility. It is advisable for the child to breathe through the mouth so that the air flow does not push the foreign body deeper - if it penetrates into the nasopharynx, there is a danger of the foreign body entering the lower respiratory tract during inhalation. You should not feed or water your child.

It is strictly prohibited:

try to remove a foreign body with tweezers, a finger or a cotton swab;
press on the nostril with a foreign body;
rinse the nasal passage with water.

Any of these actions will push the stuck object further and deeper. In addition, unsuccessful manipulations with instruments can injure the mucous membrane and cause bleeding. If there is heavy bleeding, you should call an ambulance.

If, upon examination of the nasal passages, it was not possible to see a foreign body, you should immediately contact medical care. You should also consult a pediatric otolaryngologist if a foreign body comes out when you blow your nose, but within 24 hours breathing through the damaged nasal passage has not returned to normal and copious fluid discharge continues.

Medical assistance

Removal of a foreign body from the nose is performed on an outpatient basis. The child is hospitalized only in case of complications. If, after using vasoconstrictor drops and blowing your nose, the foreign body does not come out, then under local anesthesia, the doctor removes it with a blunt hook.

If the removal attempt is unsuccessful, the issue of prompt removal of the foreign object under anesthesia is decided. If the foreign body has turned into a large nasal stone, then it is crushed with forceps before removal.

After removal of a foreign body, anti-inflammatory therapy is carried out as prescribed by an ENT doctor, even if the object was removed at home.

Prevention

Prevention of a foreign body getting into a child’s nose is as follows:

don't leave children in early age without adult supervision;
monitor the quality of toys and select them according to age;
keep small items (beads, buttons, etc.) out of the reach of children;
Remove seeds and grains from fruits before giving them to your child.

Summary for parents

It is much easier not to leave children unattended by adults than to eliminate problems that arise later. Left to his own devices, a child can easily create them. One of these problem situations there may be a foreign body in the nose. If this difficulty arises, it is better to entrust the removal of the foreign body to a doctor. Independent manipulations must be carried out very carefully, since inept actions can make it difficult to remove an object from the nose and cause complications.

The program “Live Healthy!” talks about how to remove a foreign body from a child’s nose:

Ekaterina Morozova - mother of many children, editor of the “Children” section in Colady magazine

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Everyone knows that babies should not be left alone for a minute. But even under the strict supervision of their parents, children sometimes manage to do something weird that makes mom and dad grab their heads. It’s good if it’s just scattered cereal or painted wallpaper, but what should a mother do if a foreign body gets into the baby’s nose or ear?

Signs of a foreign body in a child's nose

Children taste everything. Children often accidentally inhale beads, buttons, or construction parts or deliberately push them into their noses. Pieces of food, paper and even insects also get into the nose. What are the signs of a foreign object in your baby’s nose?

Nasal congestion on one side only.
Skin irritation at the entrance to the nose.
Discharge of mucus from the nose.
Sneezing and watery eyes may occur.

In difficult cases:

Purulent discharge with blood (when an object remains in the nose for a long time). A putrid odor may also be present if decomposition of an organic body (a piece of food, for example) occurs in the nasal passage.
Rhinosinusitis.
Purulent runny nose (on the 1st side).
Headache (1st side).

First aid for a child with a foreign body in the child’s nose - what to do and when to see a doctor?

If any object gets into your baby’s nose, first of all, remember the main rule - don’t panic! If there is no doctor (clinic) in the immediate vicinity, we do the following:

We instill vasoconstrictor drops into the child’s nose.
We close the baby's free nostril with a finger and ask him to blow his nose thoroughly.
If there is no effect, we go to the doctor.

If an object is stuck too deeply, do not try to remove it with tweezers or a cotton swab - you risk pushing it even deeper. The doctor will remove the object from the nose under local anesthesia special tool in a matter of seconds. You should consult a doctor immediately if, in the presence of a foreign body, your baby still starts bleeding from the nose.

Symptoms of a foreign body in a child's ear

Most often, mothers encounter foreign objects in the noses of their little ones in the summer. Because in nature there are more such opportunities for children, and insects are in large quantities. Sometimes the mother is not even aware that the child has been walking around with a foreign body in the ear for several days, and discovers the problem by accident - already when symptoms appear. What are these symptoms?

Decreased hearing quality.
Obvious disturbances in the usual discharge of earwax.
Inflammatory process in the ear.
The appearance of pus from the ear.
Discomfort, pain.

Rules for removing foreign bodies from the ear - what can and should parents do?

The sensation of having a foreign object in the ear, frankly speaking, is not the most pleasant. An adult immediately senses something is wrong and checks the ear for such a problem. But children, due to being “busy,” may simply not pay attention to this problem until it begins to irritate the auditory canal. The only option when the baby reacts immediately (if he is already able to speak) is when an insect gets into the ear. It is worth noting that pulling anything out of a baby’s ear on your own is extremely dangerous. From possible complications– from ear injury to eardrum rupture. Therefore, you should take on this business only if you are confident of success. So, how to save your child from a foreign body in the ear?

We carefully straighten the bends of the membranous-cartilaginous part of the external auditory canal by gently pulling the baby’s ear back or up.
We carefully study the accessibility (visibility) of the object in the depths of the ear.
If the object is in the outer part of the ear canal, carefully fish it out with a cotton swab so that the object comes out entirely.

If an object is stuck in the inside of the ear canal, it is strictly forbidden to remove it yourself - only see a doctor!

If an insect crawls into your baby's ear:

Instill a solution of glycerin or vaseline oil (warm, 37-39 degrees) into the ear as quickly as possible - 3-4 drops. It is advisable to have these products on hand, especially if you spend most of your time outside the city.
In the absence of oxygen, the insect dies after 3-4 minutes.
For some time, the feeling that the ear is blocked (due to the presence of oil) will persist.
After a few minutes, tilt your baby's head over the table so that the affected ear rests on the napkin.
Now wait (15-20 minutes) until the oil flows out. The dead insect should also “swim out” with it.
Next, you should examine the insect itself (whether it came out completely) and the baby’s ear.
If only oil has leaked, then most likely you can easily see the insect in the external auditory canal. Use a cotton swab to pull it out entirely (carefully!) so that not a single particle, even the smallest one, remains in the ear. Otherwise, inflammation cannot be avoided.

Tweezers and other tools like tweezers cannot be used - you risk simply breaking off part of the insect or pushing it deep into the ear. Not to mention possible eardrum injury.

Note to mom:

Use extreme caution when cleaning your child's ears. A cotton swab has the ability to push earwax deep into the ear all the way to the eardrum, after which the earwax itself becomes a foreign object. The result is hearing loss and sulfur plugs. There is also a chance that some of the cotton wool from the stick will also remain inside. Use a rolled cotton swab to clean your ears.