Management of Foreign body (FB) Nose
What is foreign body Nose ?
An object is considered as foreign body if its in the location where it does not belong to.
Commonly encountered in children more than 01 year and between 02 and 04 years
Sometimes also seen in adults who are mentally retarted or have a psychiatric disorder.
Most commonly encountered foreign bodies are
· Pebbles
· Slate pencil
· Eraser
· Seeds
· Button batteries
· Paper wads
Steps in removal of foreign body
· Child should be brought to ENT specialist and the foreign body should be removed in single attempt
· Child restrained in upright position
· Add a few drops of nasal decongestant
· Proper visualisation of foreign body should be done before any attempt is made to remove the foreign body
· Eustachian tube catheter or blunt curved hook is passed beyond the foreign body and pressed against nasal floor and drawn forward and removed·
Mild nasal bleeding may occur which is usually controlled by pinching the nose for about 5 to10 minutes
In the case of a larger child who resists removal, it may sometimes be necessary to remove the foreign body under General Anaesthesia.
Points To Note
Try to avoid unnecessary manipulation at home - this disturbs the child, causes pain, may cause nasal bleeding and will make subsequent attempts at removal more difficult.
When taking the child for medical care try to visit an ENT doctor in your area as they have the instruments as well as the training to remove the foreign body.
There is a manoeuvre called the 'Parent's Kiss' - In situations where medical help is not readily available one may try to occlude the normal nostril and kiss the child and blow into the mouth - this is an attempt to bring out the foreign body with air pressure. I am not sure if this is successful.
If not removed in time, or if not noticed, the foreign body can continue to reside in the nostril and cause unilateral foul smelling discharge. Special mention is made of button batteries - these can cause tremendous chemical reaction inside the nose, sometimes even leading to a septal perforation if not removed in time.
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