Nasal Foreign Bodies In Children Research Articles

Characteristics of Pediatric Nasal Foreign Body Cases That Required Multiple Removal Procedures: A Single Tertiary Medical Center Cross-Sectional Study.

Removal of nasal foreign bodies in children should be completed as few numbers of times as possible to reduce the burden on the child. This study aimed to reveal the characteristics of pediatric nasal foreign body cases that required multiple removal procedure and to investigate the appropriate removal method for each shape of foreign body. We retrospectively reviewed patients who visited a pediatric emergency department because of nasal foreign body from November 1, 2018, to October 31, 2020. We compared the characteristics of patients, foreign bodies, and treatment between the success and failure groups in the first removal procedure. Moreover, we described the detail of patients in the failure group. We also showed final successful removal methods according to the shape of the foreign bodies. We included 104 children in our analysis. Between the success and failure groups in the first removal procedure, there was no statistically significant difference in the characteristics of patients and foreign bodies but a significant difference in the removal method ( P < 0.001). In the failure groups, the most frequent number of times required for removal is 2 and the most common methods in the first removal procedure was the parent's kiss, most of which were performed on spherical foreign bodies in younger children, Finally, only 7 cases (6.7%) failed to remove the foreign body. According to the shape of the foreign bodies, the percentage of forceps and clamps used for successful removal was high in every shape. There was a significant difference in the removal method between the success and failure groups in the first removal procedure, but finally, most foreign bodies were removed by emergency physicians. Therefore, further research is needed to determine the appropriate removal method for each patient and foreign body.

278 Nasal Foreign Body Removal: Success Rates for Techniques and Devices

Nasal foreign bodies (NFB) are a common complaint in the emergency department (ED), especially among young children. The aim of this community-based study was to describe our success rate with various techniques and devices for NFB removal in a large cohort of children presenting to the ED in West Michigan. This is a retrospective cohort analysis of children (age < 19 years) presenting to the EDs of seven affiliated hospitals in West Michigan with a diagnosis of NFB. Spanning 13 counties in Michigan, affiliated institutions included three rural medical centers, three university-affiliated hospitals and a children’s tertiary care facility. All eligible cases were seen between December 2013 and November 2020 (84 months). Patient demographics, type of NFB, treatment in the ED, complications, and final disposition were recorded using a standardized abstract form. Main outcome criteria was the first-attempt success rate of each technique. Descriptive statistics (mean, SD) and 95% confidence intervals (95% CI) were used to describe key demographic and outcome variables. During the study period, 1199 children presented to the ED with a total of 1213 NFBs. Average age was 3.1 +/- 2.2 years; 55.0% were female. Forty-six different types of NFBs were identified, typically located in the right nare (57.9%) for a mean duration of 16.5 hours. Nineteen different extraction techniques were documented during the study period. First-attempt success rates included the nasal balloon extractor (95.5%), alligator or bayonet forceps (82.3%), suction catheters (67.9%), wax loop/curette (63.1%), parent’s “kiss technique” (56.6%) and hemostat (41.9%). Overall, 71.9% (95% CI, 69.3 to 74.4%) of NFB were removed on the first attempt; 19.7% (95% CI, 17.5 to 22.1%) on the second attempt; and 7.0% (95% CI, 5.6 to 8.6%) required three or more attempts. A total of 23 children (2.0%) children required sedation for the procedure. Thirty-six children (3.2%) were referred to ENT; 4 patients were admitted to surgery. Complications occurred in 46 children (4.0%) and included mild epistaxis, swallowed NFB, pain, and posterior displacement of NFB. A large number of simple removal techniques and devices are available for NFBs in children depending on the type of foreign body, location, age of the child, and degree of obstruction. These methods are not time consuming and do not require complex equipment.

Superabsorbent polymer balls as foreign bodies in the nasal cavities of children: our clinical experience

ObjectiveTo summarize the clinical diagnosis and treatment of superabsorbent polymer balls as nasal foreign bodies in children.MethodsWe retrospectively analysed the clinical data concerning 12 cases of superabsorbent polymer balls as nasal foreign bodies in children and summarized the corresponding clinical features, methods of diagnoses and treatment, and prognoses.ResultsTwelve children with superabsorbent polymer balls as foreign bodies in their nasal cavities presented with relatively severe symptoms, such as congestion, runny nose, and nasal swelling. When such foreign bodies stay in the nasal cavity for a prolonged period, patients may suffer from general discomfort, such as agitation, poor appetite and high fever. Most of the children had to undergo nasal endoscopy under general anaesthesia to have the foreign bodies completely removed. An intraoperative examination revealed significant mucosal injury within the nasal cavity. With regular follow-up visits and adequate interventions, all the patients recovered.ConclusionThe longer superabsorbent polymer balls remain in the nasal cavity, the more damaged the nasal mucosa will be. It is challenging to remove such foreign bodies in the outpatient setting. Transnasal endoscopy under general anaesthesia appears to be safer and more effective in such cases. Since the nasal mucosa is injured to varying degrees, postoperative follow-up and treatment are equally important for preventing the occurrence of complications.

Presentation and management of nasal foreign bodies in a Chinese metro area.

Nasal foreign bodies in children are common complaints encountered by pediatric otolaryngologists. We investigated clinical features, diagnosis, and treatment of nasal foreign bodies in children in a Chinese metro area.Six hundred sixty eight children with nasal foreign bodies presented to Shenzhen Children's Hospital, diagnosed and treated by the authors were enrolled from January 2016 to October 2019, causes for medical consultation, age, sex, duration, types, locations, removal, and complications were recorded and analyzed.Nasal foreign bodies were common in children between 1 and 5 years of ages (96.8%). The right nasal cavity (61.4%) was the most common site for foreign body insertion (61.4%). Most of the children (89.4%) presented for a complaint of nasal discomfort or foreign body insertion themselves, or for foreign body impaction discovered by the caregivers. Most of the foreign bodies (85.0%) were discovered within 1 day. The most nasal foreign bodies were the whole toys and toy parts (34.1%). The majority of nasal foreign bodies (99.1%) located in the antero-inferior portion of the nasal cavities and could be removed with simple instruments. The occurrence of complications in nasal foreign bodies (10.2%) was not common.The present study objectively exhibited clinical features, diagnosis, and treatment of nasal foreign bodies in a Chinese metro area.

Nasal foreign bodies in children – our experiences at a tertiary care teaching hospital in Eastern India

BackgroundChildren with nasal foreign body (FB) often come to clinician for its removal. These children often present with foul-smelling nasal discharge, nasal obstruction, nasal mucosal irritation, and epistaxis. In most cases, unilateral nasal FB is easily removed but occasionally may lead to life-threatening situation.ObjectivesTo study the details of the nasal FBs including treatment in children at a tertiary care teaching hospital of Eastern India.Patients and methodsThis retrospective study was done between June 2015 and July 2020 and included children attending the otorhinolaryngology clinic and emergency unit for nasal FB. Patient details such as age, sex, symptoms, type of FB, techniques of removal, and complications are analyzed.ResultsA total of 318 children with FB were included in this study. The mean age of the participants was 4.23 ± 1.8 years (range, 0–16 years); the male to female ratio was 1.6: 1 (male predominance). Most FB cases were owing to organic substances such as vegetables (30.81%), and nonorganic FB were paper piece, plastic piece, foam, metallic nuts, and button battery cell. The commonest clinical presentation among participating children was unilateral foul-smelling nasal discharge. Complications included epistaxis, rhinosinusitis, rhinolith, and perforation of the nasal septum.ConclusionFBs in the nasal cavities are a common accidental medical problem, especially in pediatric age. These nasal FBs are often harmless but may cause complications in some cases if neglected or overlooked without removing it in time. However, the best treatment remains the prevention.

Aural and nasal foreign bodies in children – Epidemiology and correlation with hyperkinetic disorders, developmental disorders and congenital malformations

ObjectivesForeign body incorporation in children is often a serious situation. Attention deficit hyperactivity disorder (ADHD) could be a risk factor for self-insertion of foreign bodies. Large cohort analyses are missing. MethodsThis was a retrospective analysis of patients’ records from a health insurance company representing 2.19% of the German population and 1.75% of German children and adolescents. According to the International Classification of Diseases, children in the age range between 1 and 18 years have been screened for foreign bodies in ear, nasal sinus and nostrils as well as for hyperkinetic disorders (F90), disorders of psychological development (F80–F89), and congenital malformations, deformations and chromosomal abnormalities (Q00–Q99). ResultsIn total, 12887 children (6609 male; 6278 female) have been treated in 16929 cases. The majority (n = 10041 (77.9%)) presented with foreign body incorporation on a single occasion. On average, 1.31 cases of foreign body treatment were recorded per child; 14.1% of children with foreign body treatment (FBT) also had a record of hyperkinetic disorder, 52.7% had a disorder of psychological development, and 50.8% a congenital malformation. Mean occurrence of FBT was 174.8 days before the diagnosis of a hyperkinetic disorder but 517.2 days after the diagnosis of a psychological development disorder and 683.1 days after the diagnosis of a congenital malformation, deformation or chromosomal abnormality. ConclusionPatients with disorders of psychological development as well as children with congenital malformations are high-risk patients for nasal and aural foreign bodies. The prevalence of a hyperkinetic disorder in patients with FBT is much higher than in the normal population. ADHD is a risk factor for foreign bodies.

Diagnosis and management of radio opaque nasal foreign bodies in children

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; &lt;span lang="EN-IN"&gt;Nasal foreign body impaction is a common problem in paediatric population. Children are more affected because they have tendency to put anything in the nose or by their playmates. This study is about the various radio opaque nasal foreign bodies we encountered and their management. &lt;/span&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; &lt;span lang="EN-IN"&gt;A retrospective study between January 2013 - January 2015, at Institute of child health/Madras Medical College, Chennai, was done in paediatric patients, who have accidently inserted the radio opaque foreign body in their nostrils. The case record were analysed for the nature of radio opaque nasal foreign body, the symptoms, complications encountered. &lt;/span&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; &lt;span lang="EN-IN"&gt;There were 11 patients with radio opaque foreign body in our study. The most common age group was between 1 to 5 years 7 patients were in this age group. The type of foreign was button battery were 5 in number, safety pins 4, marble 1, bolt 1. All the patients were brought to hospital within 4 hours of insertion. We did not encounter any complications while removal of the nasal foreign bodies. &lt;/span&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; &lt;span lang="EN-IN"&gt;Nasal foreign bodies are a common problem among children’s. The foreign body retrieval can be posing a great challenge to the otorhinolaryngologists. The radio opaque foreign body especially button battery, if not removed may lead to serious complications like septal perforation.&lt;/span&gt;&lt;/p&gt;&lt;p class="abstract"&gt; &lt;/p&gt;

Nasal foreign bodies in children in a pediatric hospital in Senegal: A three-year assessment

ObjectivesNasal foreign bodies (NFB) constitute a common domestic accident in children. The objectives of the present study were to report the particularities of NFBs in children presenting at a pediatric hospital in Senegal, and to describe our therapeutic attitude. Material and methodsA retrospective descriptive study included all under-15 year-olds presenting with NFB in the ENT department of the National Children's Hospital Center of Diamniadio, Senegal, between January 1, 2013 and December 31, 2015. Study variables comprised: age, gender, provenance, presenting symptoms, time to consultation, type of NFB, extraction method, and complications. Results58 NFB cases were retrieved. Mean age was 3years 4months; 93% of patients were under 5 years old. There was female predominance of 53.45%: i.e., sex-ratio, 0.87. Location was in the right cavity in 43 patients (74.1%). The presenting symptom was purulent rhinorrhea in 51.7% of cases. Time to consultation was within 24hours in 17.24% of cases. NFB type was firstly foam rubber (29.3%), followed by grain (20.7%). Extraction was performed in consultation in 84.5% of cases and in the operating room in 15.5%. Morbidity was 22.41%: 17.24% epistaxis and 5.17% nasal infection. ConclusionNFBs constitute a common domestic accident in under-5 year-olds. The rural Senegalese context shows delay in consultation.

Nasal foreign bodies in children: Types, locations, complications and removal

ObjectivesTo evaluate 1875 cases of nasal foreign body (NFB) removal with regard to type of foreign body (FB), location, complications, techniques for removal, age and gender, and to present the results of the evaluation. MethodsBetween 2006 and 2013, a total of 1875 NFBs were removed from 1870 children in ENT Services of Antalya Ataturk State Hospital and Izmir Tepecik Training – Research Hospital. A retrospective review was undertaken to evaluate the parameters related to the NFBs and their removal and the data were analyzed. ResultsThe most frequent NFBs were hard spherical objects and the most common locations to lodge were on the right side just anterior to the middle turbinate. Prolonged exposure increases the complication rate, and button batteries are particularly ominous as they drift into the airway, never observed. We found a higher incidence in patients between ages 2 and 5 years. The distribution of NFBs was 52.9% in boys and 47.1% in girls. ConclusionsNFBs are most commonly hard, round objects. Button batteries and penetrating FBs must be treated immediately. Complications from NFBs are rare but may be potentially serious or even life threatening.

Nasal foreign bodies in children: considerations for the anesthesiologist

The combination of a curious young child exploring his/her nasal cavities, with the abundance of small inert and natural objects in our society, culminates in a significant number of nasal foreign bodies (NFBs). Usually NFBs are benign entities, yielding relatively simple resolutions and mild morbidities. However, their presence can lead to much more serious consequences if they are inserted unwitnessed, grow asymptomatically for several months or years, and significantly affect surrounding tissues. Moreover, if these substances become displaced posteriorly and enter the lower respiratory tract, dire circumstances may occur. This article discusses the different types of NFBs, various clinical presentations, diagnosis, pathophysiology, and pertinent considerations for the anesthesia care provider. Increasing one's awareness of the implications of NFBs, can optimize the safe treatment of patients harboring this development.

Nasal Foreign Body Removal in Children

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.

Barotrauma: A Complication of Positive Pressure for Nasal Foreign Body Removal in a Pediatric Patient

Emergency physicians are frequently called on to remove impacted nasal foreign bodies in children. Multiple positive pressure techniques for the removal of nasal foreign bodies have been described. This case report details a previously unreported complication of barotrauma after the use of a published positive pressure technique that uses unmodulated piped hospital oxygen (wall oxygen) in the emergency department setting. We caution against the use of sustained, unmodulated positive pressure to dislodge a retained nasal foreign body.

The ‘Parent's Kiss’: An Effective Way to Remove Paediatric Nasal Foreign Bodies

The objectives of this study were to: (i) evaluate the effectiveness of 'parent's kiss' as a technique for removal of nasal foreign bodies in children; and (ii) determine whether this technique reduces the number of children requiring general anaesthesia for their removal. This was a prospective observational study in the accident and emergency and ENT departments at Luton and Dunstable Hospital. The participants were 31 children with nasal foreign bodies, under the age of 5 years, presenting via the acute services over a 6-month period. The primary outcome measured was successful removal of nasal foreign body with the 'parent's kiss' technique. Secondary outcome was reduction in the number of general anaesthetics following introduction of the technique. The technique was successful in 20 out of the 31 children (64.5%) in the study group. Only one patient required general anaesthesia for removal of nasal foreign body (3%). This compares with a rate of 32.5% requiring removal under general anaesthetic in the preceding 6-month period. The 'parent's kiss', when not successful, seemed to improve the visibility of the foreign body making their subsequent removal easier. The 'parent's kiss' is an effective technique. It is non-traumatic, both physically and emotionally, for the child subjected to it. We advocate that it should be used routinely as a first line of management in children with a nasal foreign body in the primary care setting.

Nasal Foreign Bodies in Children

To determine the proportion of children with nasal foreign bodies who had button batteries as the foreign body. To describe the clinical care and outcome of those children with a button battery foreign body. A retrospective review of all children presenting to the accident and emergency room with a nasal foreign body or unilateral nasal discharge during a 6-month period was assessed. Forty-four children were included. The most common object found was a plastic bead (27%), followed by foam, paper, or tissue fragments (23%); food matter represented 15%. A button battery was found in 3 patients (7%); other foreign bodies included stones, buttons, crayons, erasers, and a pellet. Thiry-six (82%) had their foreign body removed without anesthetic and 8 (18%) required a general anesthetic. All 3 children with a button battery went undiagnosed until examination in the operating theater. Because there was no previous indication of the presence of a button battery in the 3 children, the removal of the foreign body under general anesthesia was scheduled for the following day. The removal of the button batteries would have been expedited had a plain radiograph been obtained, possibly resulting in less morbidity for our patients. We recommend a plain radiograph in all children presenting with a nonvisible foreign body or unilateral nasal discharge.

New technique for removing nasal foreign bodies in children

Clinical OtolaryngologyVolume 32, Issue 4 p. 321-322 New technique for removing nasal foreign bodies in children M. Sithamaparanathan, M. Sithamaparanathan Department of ENT Surgery, East Surrey Hospital, Redhill, Surrey RM1 5RH, UKE-mail: [email protected]Search for more papers by this author M. Sithamaparanathan, M. Sithamaparanathan Department of ENT Surgery, East Surrey Hospital, Redhill, Surrey RM1 5RH, UKE-mail: [email protected]Search for more papers by this author First published: 20 July 2007 https://doi.org/10.1111/j.1365-2273.2007.01467.xCitations: 4Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article.Citing Literature Volume32, Issue4August 2007Pages 321-322 RelatedInformation

Nasal foreign bodies in children: a possible pitfall for the anesthesiologist

Based on a recent surprising case in our institution, we analyze the possible dislodgment of an unknown foreign body in the nose during nasotracheal intubation in children. Nasal foreign bodies made of inert material can remain unnoticed for a long period of time. In addition to inserting a close-fitting suction catheter into the TT during its passage through the nasopharynx, we now suggest performing a pharyngoscopy when intubation is completed.

Nasal positive-pressure technique for nasal foreign body removal in children

Nasal foreign bodies in children are often encountered in emergency medicine and many methods of removal exist. This study examines the nasal positive pressure technique, a method not previously described in the literature. A retrospective chart review of nasal foreign body removal using the nasal positive pressure technique was conducted, as well as, a follow-up telephone survey of patient's parents. Nine patients were identified over a 1-year period. The average time from triage to discharge was 34 minutes (15-106 minutes). No sedation, consultation or complications were recorded. Five of the 9 parents completed the survey. All 5 (100%) described the procedure less traumatic than an injection, and 4 (80%) described the procedure similar or less traumatic than an oral pharyngeal exam with a tongue depressor. Nasal positive pressure technique for nasal foreign body removal is a safe and efficient method, and it is relatively nontraumatic in the view of parents. (Am J Emerg Med 2002;20:103-104. Copyright 2002, Elsevier Science (USA). All rights reserved.)

'A parent's kiss': evaluating an unusual method for removing nasal foreign bodies in children.

Nasal foreign bodies are a common problem in children. Various techniques have been described for removing the offending articles. Positive pressure techniques have long been described, and have many potential advantages, but are not yet in widespread use. The aim of this study was to evaluate the efficacy, safety and acceptability of a technique of mouth-to-mouth blowing. Of 19 children with intranasal foreign bodies, the technique was successful in 15 (79 per cent). The procedure caused little or no distress to the child, and no complications were encountered. All parents found the technique acceptable. This technique for nasal foreign body removal is, as far as we are aware, the first to be subjected to any prospective evaluation of effectiveness. We suggest that it should be used as the first line management for removing nasal foreign bodies in young children.

Nasal foreign bodies in children.

Between 1994 and 1997, a total of 72 nasal foreign bodies were removed from 68 children (28 girls and 40 boys, including 2 repeats) in the ENT Department at Robert Debré Hospital, Paris. Ages ranged from 1 to 12.5 years (median, 3 years). Two children had bilateral foreign bodies. The unilateral foreign bodies were on the right side in 67.6% of cases. The most frequent objects were plastic objects, beads, paper, cotton and foam. Insertion was witnessed by an adult or reported by the child himself in the majority of cases. The other cases were diagnosed when complications occurred (as seen by persistent rhinorrhea and a foul body odor). All foreign bodies were removed in the consultation room using a hook or nasal forceps.

Nasal foreign bodies in children

This study investigates the pattern of pediatric nasal foreign body impaction and its management in a metropolitan area. Data was obtained from 147 children presenting to the Accident and Emergency Department over a 4-year period. The majority of foreign bodies were toys and household products. Complications which occurred, such as ingestion of the foreign body or epistaxis were usually related to attempts at removal. Fourteen cases of local complications resulted from button battery impaction. Most of these patients can successfully be managed without complication if correct procedures are adopted.