Hidden in plain sight: A decades-long journey of a nasal foreign body discovered incidentally

Nasal foreign bodies (NFBs) are commonly encountered in pediatric patients but rarely persist asymptomatically into adolescence. Typically, NFBs present with symptoms such as nasal obstruction, rhinorrhea, or foul odor. However, asymptomatic cases pose diagnostic challenges and are seldom identified without incidental findings.

We present the case of a 17-year-old male with an asymptomatic NFB discovered incidentally during routine dental radiography. The patient denied any history of nasal obstruction, epistaxis, or discomfort. Imaging revealed a radiopaque object in the right nasal cavity, later identified as a metallic snap button embedded in the floor of the nasal cavity. The foreign body had likely been retained for over a decade.

The asymptomatic nature of this case challenges the typical presentation of NFBs. The inert material of the foreign body and its location within the nasal cavity likely contributed to the absence of symptoms. This case underscores the importance of considering NFBs in differential diagnoses, even when patients remain asymptomatic. Dentists, in particular, play a critical role in identifying such foreign bodies during routine imaging, as they may otherwise go unnoticed.

This case contributes to the limited literature on long-standing, asymptomatic nasal foreign bodies. It emphasizes the need for healthcare providers, including dentists, to remain vigilant and consider foreign bodies in cases of incidental findings. Appropriate follow-up and education are necessary to prevent potential complications associated with untreated foreign bodies.