Neftaly Foreign Body in the Nasal Cavity

• foreign body (FB) lodged in the nasal passage, usually unilateral
• Most common in children aged 2–5 years
• Objects vary: beads, food particles, small toys, paper, or organic material

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???? Clinical Features

• Unilateral nasal obstruction
• Foul-smelling, often purulent nasal discharge
• Nasal bleeding or crusting
• Child may have a history of putting objects in the nose
• Possible nasal pain or discomfort
• Usually no systemic symptoms unless secondary infection develops

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???? Diagnosis

• History: Child or caregiver report of inserting object
• Physical exam: Anterior rhinoscopy with good lighting or nasal speculum
• Avoid blind nasal probing to prevent pushing the object further
• If unclear or complicated, imaging (X-ray) may help identify radiopaque FB

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????️ Management

1. Removal Techniques

• Positive pressure technique (parent blows into mouth while occluding unaffected nostril)
• Instrumental removal: Using forceps, hooks, suction
• Consider topical vasoconstrictors (e.g., oxymetazoline) and local anesthesia
• Avoid excessive attempts to prevent trauma and aspiration
• Referral to ENT if unsuccessful or if object is deeply lodged

2. Complications to Watch For

• Persistent infection or sinusitis
• Nasal septal perforation (rare)
• Aspiration into lower airway (if dislodged)

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???? Disposition

• Discharge with instructions on signs of infection or bleeding
• Follow-up if signs of complications
• Educate caregivers on prevention

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❗ Clinical Pearls

“Unilateral foul-smelling nasal discharge in a child is a classic sign of a nasal foreign body.”

“Never probe blindly; visualize before removal to avoid pushing the object deeper.”

“Positive pressure removal is quick and painless—try it before instruments.”

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