Foreign bodies impacted in the nasal cavities are common in children and in patients with psychiatric disorders or psychomotor delay . Foreign bodies can be of different types : Organic , such as seeds, peanuts, beans, seeds, among others; Inorganic , such as toy parts, paper, sponges, stones, among others. Among these, batteries and magnets deserve urgent attention, as they can cause injuries such as necrosis and perforation of the nasal septum within hours (in the case of batteries); Living foreign bodies, such as insects; Latrogenic , such as materials that are inadvertently retained after nasal surgery. Children may initially be asymptomatic, being the presence of a nasal foreign body only a suspicion of parents or caregivers. • A nasal foreign body should be suspected if there are persistent and unilateral nasal symptoms , namely: Nasal discharge (rhinorrhea) of a yellowish/greenish color with a foul smell; Nasal obstruction; Hemorrhage; Bad mouth odor; Pain; Irritability (in children). Diagnosis of a nasal foreign body In most cases, the diagnosis of a nasal foreign body is made by direct visualization because almost all have two locations in the nasal cavity: the floor or anterior to the middle turbinate. It may be necessary to decongest the nasal cavity and aspirate secretions. In rare cases, a nasal endoscopy may be useful, particularly when unsuccessful removal attempts have been made by caregivers and may have resulted in a more posterior positioning of the foreign body in the nasal cavity. Ideally, the examination should be performed with adequate lighting and equipment and with the patient still and calm. In the case of children, it is not always easy, usually because they are young, agitated and restless children, who have already had previous attempts at extraction. Above 3-4 years of age, it is possible for the child to cooperate, asking him to blow his nose with sufficient force to spontaneously expel the foreign body, or by performing nasal washes. In cases where there is already extensive inflammation or bleeding, or when a child is very agitated, it may be necessary to remove the foreign body under sedation. Possible complications of foreign bodies in the nose Removal of nasal foreign bodies is necessary to avoid chronic inflammation with sequelae, such as nasal septum perforation or nasal deformity. If a nasal foreign body is not removed, formation of rhinolith (calcium crystals around the foreign body, associated with nasal obstruction and chronic sinusitis) and migration of the foreign body to the lower airways (which is possible, but it is rare) may occur. When to see an otolaryngologist The care of an otolaryngologist should be sought: Whenever there is an impacted foreign body in the nasal passages not accessible for easy removal by caregivers or other health professionals; After several unsuccessful removal attempts; When there are nasal symptoms , predominantly unilateral, particularly bleeding or purulent nasal discharge, leading to suspicion of the presence of a foreign body; When sedation is required for a safe removal. This article was written by the Hospital da Luz otorhinolaryngology team. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
