Dislodging Foreign Bodies From A Child’s Nose
Children under the age of five are extremely inquisitive and busy exploring the environment surrounding them. And as a part of this, they explore their bodies too. Consequently, they end up inserting small objects what we call as foreign bodies in to their nose, ear and mouth.
What is a foreign body? A foreign body is essentially an object that is not naturally supposed to be there (hence ornaments unless displaced do not fall in to this category). Children under the age of five are at the highest risk but even an adult can end up choking on a fish bone and not to forget the recent case of a chain snatcher who ingested the stolen chain and the foreign national arrested for carrying load of drugs in her body.
Foreign bodies in children are more predictable like small parts of toys, pieces of crayons, erasers, tissue paper, modelling day, battery cells, marbles, food, thermacol beads and pebbles. Among these, the most dangerous are metallic foreign bodies because they can react and cause sloughing of the tissues. The other dangerous foreign body is vegetable matter which swells up immediately. Usually doctors come across thermacol beads which have been accidentally sniffed up the nose while playing or it could be a crayon, eraser piece etc.
Signs And Symptoms
Usually children with foreign bodies in the nose, have a dear-cut history of a parent actually witnessing the incident or noting soon after the insertion. Mostly, it happens as a result of playfulness or accidents. Sometimes. it occurs due to a dry nose, irritation in the nose or a result of allergy. Not very uncommon is a child exhibiting a chronic nasal discharge which may be foul smelling or bloody. If the foreign body is big enough in the nose, it can cause noisy breathing, stridor or difficulty in breathing if it has slipped in to the throat or lower airways.
Most of the time, the history and examination are quite indicative. Sometimes, when it is not obvious and the foreign bodies are radio opaque (metallic or calcitic) which is a rarity, an X-ray can help. When it comes to treatment, simple sniffing out, that is to exhale or breathe out through the affected nostril while closing the other nostril will generate enough pressure to dislodge and remove the foreign body. Instructing the older child might help. However, it is wiser to visit the hospital as attempts sometimes might push it further inside with the consequent danger of serious choking or breathing problems.
Treatment is simple in most cases, by removal of the foreign body with an appropriate instrument like forceps with or without sedation. The most common site of oœurrence is either in the inferior turbinate or middle turbinate anteriorly which can be approached safely. Other techniques employed are suction and catheter placement with inflation of the balloon. Usually a check is done to exclude foreign bodies also in the ears as children often insert in to more than one orifice.
Do’s And Don’ts In A Nutshell
Don’ts
- Do not panic
- Do not try to remove at home unless it appears too easy as there is a high risk of ptbhing it further inside.
- Do not wait at home if there is any breathing difficulty or noisy breathing.
- Do not allow children to play with toys with small parts.
- Do not leave children unattended with crayons, erasers etc.
- Do not feed below five years old children with nuts or seeds.
Do’s
- Approach your paediatrician/ ENT doctor if there is prolonged one sided nasal discharge, foul smelling or bloody.
- See your doctor if you’re child has long standing bad breath.
- Evaluate your child if your child has repeated nasal allergies or a long standing cough.