- 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
???? 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
???? 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
????️ 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)
???? Disposition
- Discharge with instructions on signs of infection or bleeding
- Follow-up if signs of complications
- Educate caregivers on prevention
❗ 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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