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Nasal foreign body removal in children
James R Kiger1, Timothy E Brenkert, Joseph D Losek
1Pediatric Department, Medical University of South Carolina, Charleston, USA.
Insights
Nasal foreign bodies in children, often toys, are removed using various emergency department techniques. Prompt removal is crucial, especially for magnets and button batteries, to prevent serious complications like tissue damage.
Area of Science:
- Pediatric Emergency Medicine
- Otolaryngology
Background:
- Nasal foreign bodies are common in young children (2-4 years old).
- Plastic toys and beads are the most frequent objects found.
Purpose of the Study:
- To review management techniques for pediatric nasal foreign bodies.
- To highlight associated risks and potential complications.
Main Methods:
- Overview of positive-pressure expulsion techniques (oral, nasal).
- Description of direct mechanical extraction methods (forceps, hooks, catheters).
- Discussion of saline irrigation as a removal method.
Main Results:
- Multiple removal techniques exist, each with unique risks and benefits.
- Complications include aspiration, trauma, infection, and choanal stenosis.
- Button batteries and magnets necessitate immediate removal due to necrosis risk.
Conclusions:
- Effective management strategies are available for nasal foreign bodies in children.
- Awareness of potential complications guides treatment decisions.
- Urgent intervention is critical for hazardous materials like magnets and button batteries.
Abstract:
Nasal foreign bodies in children are often managed in the pediatric emergency department. The child is usually between 2 and 4 years old, and the foreign body is most commonly a plastic toy or bead. Nasal foreign bodies are removed by a number of techniques. Positive-pressure expulsion is accomplished by orally applied pressure via a parent's mouth or an Ambu bag or by nasally applied pressure via a catheter or an oxygen source. The object can be washed out with nasally applied saline. Direct mechanical extraction is possible with a variety of tools, including forceps, hooks, or balloon-tipped catheters. Each method carries its own risks and benefits. Serious complications of nasal foreign bodies include posterior dislodgement and aspiration, trauma caused by the object itself or removal attempts, infection, and choanal stenosis. Magnets and button batteries require emergent removal as they carry the risk of septal perforation or necrosis, which may develop within a relatively short time.
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