Foreign Bodies In The Nose And Rhinoliths

Introduction

Children often insert various objects into the nostrils while playing including pieces of plastic toys, rolled paper, foam, seeds, some metal objects, etc.
The objects may remain undetected for long periods, particularly organic items, until they become infected.
Typically result in foul smelling unilateral nasal discharge.
Some inorganic objects may (after long
periods) become coated by hard calcific
deposits and become known as rhinoliths .

Symptoms and clinical features

  • Often no indication or symptom
  • May be accidentally noticed by parent
  • Later, complaints of foul purulent unilateral nasal discharge of unknown origin

Differential diagnoses

  • Acute or chronic rhinitis
  • Sinusitis
  • Nasal growth/polyp

Complication

  • Secondary infection: rhinosinusitis

Investigation

  • Radiograph of nose: for metallic or radio opaque objects

Treatment objectives

Remove object safely with little discomfort to patient

Non-drug treatment

  • Careful removal with appropriate hook or forceps
  • Removal under anaesthesia as necessary

Prevention

  • Vigilant supervision of young children