Abstract
Foreign bodies of the nose are mostly common in paediatric population. In teenagers and adults, they are predominately seen in patients with mental disturbances. Usually with acute presentation, they also can remain in place for a long time. The main clinical presentation is unilateral purulent rhinorrhea possibly associated, in chronic cases, to nasal deformities, nasomaxillary abnormalities or rhinolithes. The removal can require a surgical procedure under general anaesthesia specifically in front of neglected foreign bodies covered by mucosa or previous multiple failed attempts. We report the case of a 14-years-old girl, with mental retardation, who consulted in our structure for a swelling in the left nasal alar base evolving progressively since 4 months, with intermittent purulent rhinorrhea not improved after medical treatment. No incident of nasal foreign body insertion was reported or witnessed by the patient and its family. The facial CT scan confirmed the diagnosis and the removal required surgical procedure. The diagnosis of neglected nasal foreign body should always be considered in front of unilateral nasal obstruction and discharge specifically in children and mentally disabled patients. Its removal should be rapid in order to avoid the constitution of rhinolithes and nasal deformities.
Highlights
Nasal foreign bodies are usually seen in emergency mostly in children or in adults with psychiatric illness or mental disabilities. [1] The nasal foreign body may be clinically obvious or may require further endoscopic exploration
The removal can require a surgical procedure under general anaesthesia in front of neglected foreign bodies covered by mucosa or previous multiple failed attempts
We report the case of a 14-years-old girl, with mental retardation, who consulted in our structure for a swelling in the left nasal alar base evolving progressively since 4 months, with intermittent purulent rhinorrhea not improved after medical treatment
Summary
Nasal foreign bodies are usually seen in emergency mostly in children or in adults with psychiatric illness or mental disabilities. [1] The nasal foreign body may be clinically obvious or may require further endoscopic exploration. [1] The nasal foreign body may be clinically obvious or may require further endoscopic exploration In some cases, it can still silent for weeks, months, or even years after insertion. The clinical examination of the nasal cavity showed hypertrophic left inferior turbinate with inflammatory pituitary mucosa and thick secretions. The facial CT scan allowed the visualisation of a nasal foreign body with the shape of a cup, measuring 1.5 cm, located behind the left inferior turbinate, totally covered by mucosa with an inflammatory reaction and thickening of all the surrounding tissues causing the alar region deformation with no bone or cartilage lysis. The first step consisted on an exhaustive exploration of the nasal cavity finding a hypertrophic inferior turbinate, an inflammatory mucosa, with no foreign body to be seen. The nasal fossa was clean with normal turbinates and the deformity disappeared as the tumefaction progressively decreased
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