To X-Ray or Not to X-Ray? Discussing Unknown Nasal Foreign Bodies and Button Batteries

Area of Science:

• Pediatric Otolaryngology
• Medical Imaging
• Emergency Medicine

Background:

• Nasal foreign bodies in children are common but often unwitnessed.
• Esophageal button batteries are emergent, while nasal foreign bodies are often considered non-emergent.
• Timely diagnosis and intervention are crucial for pediatric nasal foreign bodies.

Observation:

• A case of a child with a suspected pen-nib in the nostril highlights the need for thorough investigation.
• Literature review identified 15 papers on nasal foreign bodies and X-ray use.
• Only 3 papers recommend plain radiographs for nasal foreign bodies.

Findings:

• Plain radiographs are recommended in 3 of 15 reviewed papers for nasal foreign bodies.
• Facial X-rays can aid in diagnosing unwitnessed pediatric nasal foreign bodies.
• Metallic foreign bodies are particularly important to identify via imaging.

Implications:

• Facial X-rays should be considered in cases of unwitnessed pediatric nasal foreign body insertion.
• Early imaging can prevent complications associated with retained nasal foreign bodies.
• This approach emphasizes proactive management in pediatric airway emergencies.