A foreign body appears in the nose different reasons children most often face this problem. preschool age but it happens to adults too. A foreign object sometimes does not cause any symptoms, but it can also give serious complications, so it is important to seek medical attention in time. medical care and extract it. Let us consider in more detail how pathology manifests itself in different situations, and what features it has.

Where do they come from

Foreign bodies of the nose are objects accidentally or intentionally caught in the nostrils. Children themselves put themselves in the hole small particles It happens out of curiosity. In adults, mostly accidental penetration of objects is observed. They can get in for the following reasons:

• while playing with children;
• when swimming in open water;
• when inhaling air (it may contain dust, insects and other small particles);
• when eating;
• during vomiting.

Foreign bodies in the nose can even appear in people who carefully monitor personal hygiene and do not try to stuff any objects into their nostrils. A high probability of accidental penetration of small particles is observed when vomiting or eating. The penetration of pieces of food occurs by casting through the choanal openings connecting the pharynx with the nose.

Causes

There may be a sensation of a foreign body in the nostrils for various reasons. Often objects enter the nostrils naturally - by inhalation of air or improper handling different things. However, there are cases when, during a surgical intervention, the doctor leaves cotton swabs, various tool tips, or other parts of the working equipment in the passage. In this case, the pathology is of iatrogenic origin.

Severe injury can result in pieces of glass, stones, wood, and other objects entering the nostrils. Foreign bodies can be located throughout inner surface nose.

If they got into it naturally, then it is most likely that the doctor will find them in the lower nasal passages, but there are cases when an object sticks into the nasal septum or nasal concha. It also happens that with the inhaled air, particles move into the nasopharynx.

Types of particles

The presence of a foreign body in the nose is determined either by the patient himself or by the doctor. A variety of objects can get into the nostril. To make it easier to decide how to remove them, all particles were divided into main groups:

There is also a division of foreign bodies in relation to visibility in radiography. If an object can be visualized during examination, it is radiopaque. These are mainly small inorganic and solid organic objects.

If the picture does not show any changes, then we can say that the body is non-radiocontrast. Basically, food particles and living organisms, which tend to decompose in the nose, are not visible on the film.

How to recognize

If something gets into the nose and causes discomfort, you should immediately consult a doctor. However, the patient does not always notice how small particles penetrate the nostrils, sometimes the situation does not betray itself at all, or the violation is “disguised” as other diseases. In this case, you should pay attention to a number of accompanying symptoms that most often disturb the patient:

If these signs appear, then a foreign body that has entered the nose interferes with normal life. Untimely access to a doctor can lead to the addition of secondary infections and a number of complications.

Symptoms of prolonged presence of foreign objects in the nose are:

• bad smell from the nose (a consequence of the decomposition of organic or living foreign bodies);
• purulent discharge;
• inflammation and soreness of the mucous membrane;
• unilateral headache;
• the formation of rhinoliths;
• loss of appetite;
• sleep disturbance.

Possible complications and risks

Remove the object that interferes with normal breathing and living, you need to immediately. If you ignore this, you may serious problems with health. Untimely seeking medical help leads to the fact that foreign bodies cause such complications:

Bodies of organic origin can change their volume, size and even consistency if they are in the nasal passages for a long time. For example, beans or peas can become enlarged under the influence of mucus, in which case there is a complete or partial respiratory failure in the affected nostril. Also, living organisms and plant particles can decompose or fall apart.

The most dangerous thing is when rhinolite begins to form around a metal or inorganic object - a stone consisting of salts that contain mucus. Rhinolith can be smooth and rough, soft and hard, it constantly irritates the mucous membrane, which leads to a chronic runny nose.

Also, with a long stay of a foreign body in the nostril, granulation tissue grows, which makes it difficult to diagnose and causes frequent bleeding.

Features of diagnosis

An otolaryngologist (ENT) is engaged in identifying the problem. In some cases, rhinoscopy is enough to make a diagnosis - an examination with the help of special tools. If the object has moved to the lower section, then fibrorhinoscopy is needed. In this case, the doctor must process nasal cavity epinephrine to relieve swelling that prevents normal examination of the affected nostril.

If the object cannot be considered, then it is probed with a special metal probe made of metal. However, the tool helps to recognize only dense bodies.

With the addition of concomitant infections and the impossibility of conducting a normal visual examination, methods such as ultrasound diagnostics, fluoroscopy, computed tomography and magnetic resonance imaging are used. Be sure to take a bakposev of mucus from the patient.

Methods for removing objects from the nostrils

It is important for patients to remember that the sooner they come to the ENT for examination, the more chances they have to quickly and painlessly get rid of the foreign body. If you consult a doctor in time, you can avoid the appearance of edema, inflammation and the growth of granulation tissue, which makes it much more difficult to remove objects from the nostrils. Otolaryngologists use the following body extraction methods:

1. Blowing. This is the easiest way to help get rid of a foreign object. In order for the procedure to be successful, the patient must close the healthy nostril with his finger, draw full lungs of air and exhale it with great force through the diseased nostril. Small and smooth objects simply “fly out” when performing such a manipulation, relief immediately sets in, breathing resumes and discomfort disappears.
2. Endoscopy. Endoscopic removal is indicated for children and adults who could not get rid of the problem with blowing. In this case, both local anesthesia and general anesthesia can be used. The body is removed from the nasal passages with a blunt hook, with which the ENT picks up small particles and removes them.
3. Surgical intervention. It is shown only in the most difficult cases, it is performed under general anesthesia. If it is necessary to get rid of foreign objects around which rhinoliths have formed, the stones are immediately crushed, and only then they are taken out together with foreign bodies.

Mandatory during the removal of objects are procedures such as disinfection of the mucous membrane, washing the nostrils, the use of vasoconstrictor drops. Also, in some cases, it is required to wash the sinuses, establish drainage. If a foreign body caused the addition of secondary infections, they are also treated.

Prohibitions and warnings

The patient must remember that getting a foreign body into the nasal passage is a good reason to visit an otolaryngologist. It is forbidden to carry out any manipulations on your own, as you can only aggravate the situation. It is also impossible to take such measures:

A good prevention would be to follow basic safety rules. Children should not be left alone with small objects, cereals and other particles that can theoretically be put into the nostril. They should also choose toys that do not contain small parts.

Adults should wear personal protective equipment if they know there is a high chance of foreign bodies being introduced by inhaling air. Eat food slowly to avoid reflux. Airways, do not swim in dirty waters where organisms that easily enter the nose can be found.

Summing up

A foreign body can get into the nostril different ways. Violation often does not show any signs, but causes some discomfort, similar to the symptoms of a cold.

If you find the first signals that indicate the presence of foreign objects in the nose, you should consult a doctor. It is important to remove the particles in time so that they do not cause the development of complications.

• What are foreign bodies in the nose
• Symptoms of foreign bodies in the nose
• Treatment of foreign bodies in the nose

What are foreign bodies in the nose

Foreign bodies in the nasal cavity are predominantly found in children. younger age(up to 5-7 years).

What causes foreign bodies in the nose

During the game, children put various objects up their noses and their peers. Sometimes foreign bodies enter the nose when it is injured or when vomiting through the nasopharynx. Exceptionally rarely, impacted teeth are found in the nasal cavity as a result of a violation of their development. In older children, small swabs are sometimes found in the nose, left after the nosebleed stopped. The ingress of foreign bodies into the nasal cavity is possible with penetrating wounds of the face. A foreign body can penetrate into the choanae with inept attempts to remove it from the nasal cavity.

Pathogenesis (what happens?) during foreign bodies in the nose

Foreign bodies of the nose are extremely diverse in shape, size and character.

1. Organic (pieces of food, fruits, vegetables, seeds of cereal plants, fruit seeds, pieces of paper, matches, etc.).
2. Live foreign bodies (insects, leeches, worms, larvae).
3. Inorganic (small buttons, beads, stones; parts of plastic toys; pieces of foam rubber, sponges, paper, cotton wool).
4. Metal (coins, buttons, badges, screws, buttons, pins, needles, nails, fragments of firearms, etc.).
5. Radiopaque and non-contrast.

Symptoms of foreign bodies in the nose

Foreign bodies are mostly localized in the common nasal passage, but can be in the lower or middle nasal passage, on the eve of the nose and deep in the posterior parts of the nasal cavity, in the choanal region.

The main, sometimes the only sign of a foreign body in the nasal cavity is one-sided nasal congestion.

With a long stay of foreign bodies, purulent discharge with an admixture of blood appears, a sharp putrefactive odor from the corresponding half of the nose, especially with decaying organic foreign bodies, skin irritation at the entrance to the nose.

Initial reactions to a foreign body (sneezing, lacrimation, unilateral watery discharge) usually disappear quickly.

A long stay in the nasal cavity of a foreign body leads to the formation of rhinoliths (nasal stones) as a result of the deposition of phosphate and calcium carbonate with the development of reactive inflammation of the mucous membrane and the formation of bleeding granulation tissue. The development of rhinosinusitis rare cases osteomyelitis.

Unsuccessful attempts to remove a foreign body are accompanied by trauma to the mucous membrane, bleeding, advancement of a foreign body into the deeper parts of the nasal cavity, into the nasopharynx, from where it can enter the respiratory tract and esophagus.

Diagnosis of foreign bodies in the nose

Diagnosis is based on the data of anamnesis, endoscopy, and, if necessary, radiography of the nasal cavity. To identify contrasting foreign bodies, a simple radiography is performed, if an organic foreign body is suspected, with a contrast agent. Radiography allows you to establish not only the presence of a foreign body, but also its nature and localization.

Identification of a foreign body in children is hampered by the lack of anamnestic data, since foreign bodies often enter the nose in the absence of adults. Fearing punishment, children often hide this from their parents, and subsequently forget, and only with the development of the disease are all its circumstances clarified.

A long-term unilateral purulent process in the nasal cavity in a child should always alert doctors in terms of a foreign body.

by the most reliable method diagnosis remains anterior and posterior rhinoscopy, as well as fibrorhinoscopy when a foreign body is located in the posterior parts of the nasal cavity. The mucous membrane of the nasal cavity in such cases is carefully anemized with an adrenaline solution to reduce swelling. If after that the foreign body cannot be detected, the suspicious place is carefully probed with a bellied probe after local anesthesia, which gives a positive result only with solid foreign bodies.

Differential diagnosis. Differentiate with diseases of the paranasal sinuses, nasal diphtheria and neoplasms.

Treatment of foreign bodies in the nose

Foreign bodies of the nose are removed on an outpatient basis, with complications, patients are hospitalized.

The simplest and affordable way- blow your nose (especially when not large sizes foreign body) after instillation of a vasoconstrictor solution.

If the foreign body is not isolated, it is removed under local anesthesia with the help of a blunt hook, which, under the control of vision, is brought from above behind the foreign body and removed with a sliding movement along the bottom of the nasal cavity.

AT difficult cases this operation is performed under anesthesia, especially after repeated unsuccessful attempts, with large wedged or acutely end foreign bodies, as well as in children with neurotic reactions.

Due to the possibility of displacement of a foreign body into the deep parts of the nose, the nasopharynx and respiratory tract, it is forbidden to remove rounded foreign bodies from the nose with forceps or tweezers. This does not apply to foreign bodies of a different shape (pieces of paper, rubber, matches).

Rhinolith is removed in the same way. Large rhinolitis is pre-crushed with forceps in the nasal cavity.

Which doctors should you contact if you have foreign bodies in the nose

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Foreign bodies in the nose are especially often observed in children, and all because it is the children who in most cases put both pebbles and beads, seeds, buttons, and many other very diverse objects into their nasal cavity. Often, children put certain objects not even into their nasal cavity, but into the nose of the children who play with them. In adults this phenomenon extremely rare. As a rule, it is a consequence of gunshot wounds or wounds by some household item or melee weapons. The tip of the weapon in all these cases is fixed in bone tissue nasal cavity, after which it breaks off. If a foreign body was introduced into the nose through the vestibule of this organ, then most often it can be found in the area between the inferior turbinate and the nasal septum. In all other cases, the object can be located anywhere.

A long stay of a foreign body in the nose leads to the fact that over time it becomes overgrown with tissue elements. Such elements in medicine are called granulations. As a result, on the face of a nasal stone called rhinolite. Immediately, we note that rhinoliths can be characterized by a very diverse size, as well as various forms. Sometimes the so-called crypt of the nasal cavity is formed.

An otorhinolaryngological examination helps to identify a foreign body. Sometimes x-rays or computed tomography are also performed. These examinations are necessary in the presence of acute sinusitis, the origin of which remains unclear. If a foreign body gets into the nose, immediately close the free half of the nose with your finger and blow your nose thoroughly. If you have any drops on hand that have a vasoconstrictive effect, then before blowing your nose, drip drops to start. If this does not help, then call ambulance or visit a doctor's office.

The doctor will easily remove any foreign body from your nasal cavity. In this case, before the procedure, specialists do local anesthesia of the mucous membrane of the nasal cavity, after which, using a special tool, they remove foreign object. A hook acts as a special tool, with the help of which it is possible to remove an object in a matter of seconds. Remember, this procedure can only be performed under conditions medical institution. In no case do anything on your own, so as not to push the foreign body even further. If a large object gets stuck in the nose, then surgery is most often performed to remove it.

Ekaterina Morozova — mother of many children, editor of the "Children" column in Coldy magazine

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Everyone knows that babies should not be left alone for a minute. But even under the strict supervision of parents, children sometimes manage to do something that mom and dad grab their heads. It’s good if it’s just scattered cereals or painted wallpaper, but what should mom do if a foreign body gets into the baby’s nose or ear?

Signs of a foreign body in a child's nose

Children taste everything. Often, beads, buttons, designer parts are accidentally inhaled by kids or deliberately pushed into their noses. Pieces of food, paper and even insects also get into the nose. What are the signs of a foreign object in a baby's nose?

• Nasal congestion on one side only.
• Irritation of the skin at the entrance to the nose.
• Discharge of mucus from the nose.
• There may be sneezing and watery eyes.

In difficult cases:

• Purulent discharge with blood (with a long stay of the object in the nose). A putrid odor may also be present if an organic body (a piece of food, for example) is decomposing in the nasal passage.
• Rhinosinusitis.
• Purulent runny nose (on the 1st side).
• Headache (on the 1st side).

First aid for a baby with a foreign body in the nose of a child - what to do and when to see a doctor?

If any object got into your baby's nose, first of all, we remember the main rule - do not panic! In the absence of a doctor (polyclinic) in the immediate vicinity, we do the following:

• We instill vasoconstrictor drops in the child's nose.
• We close the baby's free nostril with your finger and ask you to blow your nose thoroughly.
• If there is no effect, we go to the doctor.

If the item is stuck too deep, do not try to get it out with tweezers or a cotton swab - you risk pushing it even deeper. The doctor will remove the object from the nose under local anesthesia with a special tool in a matter of seconds. A doctor should be contacted immediately if, in the presence of a foreign body, the crumbs still have nosebleeds.

Symptoms of a foreign body in a child's ear

Most often, mothers encounter foreign objects in the noses of their little ones in the summer. Because in nature there are more such opportunities for children, and insects are in in large numbers. Sometimes the mother is not even aware that the child has been walking with a foreign body in the ear for more than a day, and discovers the problem by chance - already when symptoms appear. What are these symptoms?

• Decreased hearing quality.
• Obvious violations in the habitual discharge of earwax.
• Inflammatory process in the ear.
• The appearance of pus from the ear.
• Discomfort, pain.

Rules for removing foreign bodies from the ear - what can and should parents do?

Feelings in the presence of a foreign object in the ear, frankly, are not the most pleasant. An adult immediately feels something is wrong and checks the ear for such a nuisance. But kids, due to "busyness", may simply not pay attention to this problem until it starts to irritate the auditory canal. The only option when the baby reacts immediately (if he is already able to speak) is when an insect enters the ear. It is worth noting that pulling something out of the crumbs ear on your own is extremely dangerous. From possible complications- from an ear injury to a ruptured eardrum. Therefore, you should take up this business only if you are sure of success. So, how to save your child from a foreign body in the ear?

• Gently straighten the curves of the membranous-cartilaginous part of the external auditory canal by gently pulling the baby's auricle back or up.
• We carefully study the accessibility (visibility) of the object in the depths of the ear.
• If the object is located in the outer part of the ear canal, carefully fish it out with a cotton swab so that the object comes out entirely.

If the object is stuck in the inner part of the ear canal, it is strictly forbidden to remove it yourself - only see a doctor!

If an insect has crawled into the baby's ear:

• As quickly as possible, instill a solution of glycerin or vaseline oil (in the form of heat, 37-39 degrees) into the ear - 3-4 drops. It is advisable to have these tools on hand, especially if you are most time outside the city.
• In the absence of oxygen, the insect dies after 3-4 minutes.
• For a while, there will be a feeling that the ear is stuffed up (due to the presence of oil).
• After a few minutes, tilt the baby's head over the table so that the affected ear falls on the napkin.
• Now wait (15-20 minutes) until the oil flows out. Together with him, the dead insect should “swim up”.
• Next, you should examine the insect itself (whether it came out completely) and the baby's ear.
• If only oil has leaked out, then most likely you can easily see the insect in the external auditory canal. Pull it out with a cotton swab (carefully!) Wholly so that not a single, even the smallest particle remains in the ear. Otherwise, inflammation cannot be avoided.

Tweezers and other tools like tweezers cannot be used - you risk simply breaking off part of the insect or pushing it deep into the ear. Not to mention the possible injury to the eardrum.

Note to mom:

Be very careful when cleaning your child's ears. A cotton swab tends to push earwax into the depths of the ear to the eardrum itself, after which the wax itself becomes a foreign object. As a result, hearing loss and sulfur plugs. There is also a chance that some of the cotton from the stick will also remain inside. Use a rolled-up cotton swab to clean your ears.

Small objects - buttons, beads, food, insects - can get into the nasal passage either accidentally or deliberately. During the game or out of interest, children introduce objects that are suitable in size into the nasal cavity. For parents, the main thing is to detect these bodies and remove them as soon as possible on their own or from an otolaryngologist. A timely removed object will help to avoid inflammation, the occurrence of rhinolitis and lowering it into the middle sections or pharynx.

Causes of the appearance of a foreign body in the nasal cavity

Most often, children aged 3–7 years old turn to otolaryngologists for a foreign object in the nose. A child can put a small object into the nostril during the game or, thinking about it. Sometimes children choke on food, a piece of which can also get into the nasal cavity. Vomiting can be the cause of food particles getting in. When it occurs, part of the child's vomit may flow into the nasal passages, and large pieces can get stuck in them.

You should be alert if your child has the following symptoms:

• hard breath;
• clear mucus is discharged from one nostril;
• started bleeding;
• a nasality appeared in the voice;
• the child notes pain, dizziness;
• disturbed appetite and sleep.

When a foreign body in a child's nose is present for a long time, the symptoms will be different:

• purulent discharge appears;
• an unpleasant odor will be felt from the nose;
• stones are formed - rhinoliths;
• the mucous membrane becomes inflamed, reddens.

Types of foreign objects in the nose

Foreign objects that a child can intentionally or accidentally put into the nostril vary in size and shape:

1. Organic. It can be seeds, seeds from fruits, pieces of vegetables.
2. Inorganic. Most often, these are objects that surround the child at home or in kindergarten(school) - buttons, beads, pieces of foam rubber or cotton wool, paper, polyethylene.
3. Live foreign objects - midges, larvae - can get into the nose during a walk.
4. Metal objects - carnations, badges, buttons, small coins.

In addition, objects may be radiosensitive and non-contrast. Depending on the shape and size, a decision is made on how to extract the body from the cavity. Small, soft, rounded bodies may well come out on their own or be removed by parents. However, if a child puts a sharp or large object (a button, a needle, a carnation) into himself, you should immediately seek medical help.

Objects can enter the cavity in several ways:

1. Violent way - the children themselves put various small objects into the cavity or they get there due to injury.
2. Iatrogenic way - after medical manipulations in the nose in children, parts of cotton swabs, instruments (for example, tips) may remain.
3. Insects, dust and other objects from the environment can naturally enter.
4. Through the choanal openings or the pharynx, small pieces of food enter the cavity if the child chokes.

Complications

Long-term presence of a foreign body in the nasal cavity can lead to serious complications:

• chronic runny nose, sometimes - purulent;
• the formation of stones;
• labored breathing;
• rhinosinusitis;
• headache.

If the body is not removed in time, an inflammatory process may begin. If organic objects (insects, plants) enter, an unpleasant smell of decomposition will be felt. In addition, the object can get deeper, from where it will be extremely difficult to extract it.

Rhinolith is the most serious complication of a long stay of a foreign object. Lime and phosphate salts of calcium and magnesium settle on its surface. Mixing with mucus, peculiar capsules are formed, which can be soft and hard, have a smooth or rough surface. In any case, such a “growth” irritates the mucous membrane, which leads to an ongoing runny nose.

Soon the discharge becomes purulent, inflammation progresses. The child is worried about lacrimation, headaches, often even one-sided. Sometimes when you blow your nose, clots of mucus with blood streaks come out. If the rhinolitis is large enough, deformity of the entire face may occur.

Complications of rhinolitis are very dangerous:

• sinusitis;
• otitis;
• frontitis;
• chronic rhinitis;
• bleeding;
• purulent rhinosinusitis;
• Osmeomyelitis of the bones of the nose;
• partition perforations.

Which doctors should be contacted if there is a suspicion of a foreign body in the nose of a child?

The otolaryngologist is engaged in extracting objects from the nasal cavity. It is worth visiting as soon as the parents discovered a foreign object or there was a suspicion of its presence. If the child is old enough (over 2 years old), you can gently try to remove the object at home. But even after a foreign body has come out of the nose, it is necessary to show the child to a specialist. It is important to make sure that there are no rhinoliths, abrasions, inflammations in the cavity or on the mucous membrane, and the object has come out completely.

An otolaryngologist performs diagnostics - rhinoscopy. If the object has fallen into the lower part of the nose, fibrorhinoscopy is performed. To reduce swelling and increase the area of ​​examination, the nasal membrane is treated with adrenaline before examination. As a result of diagnostics, in most cases it is possible to establish the size and location of the object.

In the case of a long-standing presence of a foreign object in the nose, it may not be possible to see it visually during the diagnostic process. Then a metal probe is used to “feel” the nasal passages. It is difficult to examine babies up to 1-2 years old - they cannot describe their feelings, it is difficult to keep them in a static position for diagnosis. In such situations, ultrasound diagnostics, tomography of the sinuses, radiography or bacterial culture may be prescribed.

Removal of a foreign body from the nose and treatment of consequences

Parents can carry out independent manipulations to remove a foreign body only if the child is old enough and can clearly follow the instructions. Children under 4-5 years of age should be immediately shown to a specialist.

If a foreign object is in front of the nasal passage and is visible to the naked eye, first aid can be provided by parents:

1. Pinch the “clean” nostril of the child, tilt the head slightly forward and ask the child to blow his nose strongly.
2. Induce a sneeze by having your child sniff black pepper or have them look at the bright sun. When sneezing, try to pinch the free nostril so that all the air comes out of the nasal passage “clogged” with the object.
3. Ask the child to breathe only through the mouth if it is impossible to remove the object so that it does not penetrate deeper into the nasal cavity.

Under no circumstances should you try:

• remove the body with tweezers, a stick or other long object;
• try to remove the body with your fingers;
• do not instill the nose with vasoconstrictor drugs and do not rinse it with water;
• do not press the nasal passage with an object stuck in it with your hand;
• do not feed or water the baby before removing the item.

Foreign bodies are removed from the child's nose on an outpatient basis. The otolaryngologist, using a blunt hook, introduces it into the nasal cavity and hooks the object. Before this, the mucosa is treated with a local anesthetic. Along the bottom of the cavity, an object hooked from above with a hook is brought out.

In cases where the object is very far away, and it was not possible to extract it in another way, an operation is prescribed. It is carried out under anesthesia. Rhinoliths are surgically removed, which are crushed before that, as well as in the case of perforation of the nasal septum, the introduction of a foreign body into soft tissues, and so on.

Further treatment is aimed at disinfecting the mucosa and eliminating inflammatory process. After removing the body, a weekly instillation of the nasal passages with disinfectant drops is often prescribed to relieve swelling and inflammation.

Foreign bodies in the nose of children are not uncommon. Especially often this happens with babies under the age of 4-5 years. Even a teenager is not immune from getting into the nose of insects or other particles from the air. However, an adult child will talk about his feelings and complain about pain. In preschoolers, it is not easy to detect a body in the nose, it is necessary to pay attention to the accompanying symptoms - a runny nose that does not go away for a long time, especially with an admixture of blood, congestion of only one nostril, nasality when talking. Some children may unknowingly pick their nose while trying to retrieve an object.