Intranasal foreign bodies: A 10-year analysis of a large cohort, in a
tertiary medical center
Objective: To describe the occurrence, clinical presentation and
management, of pediatric nasal foreign bodies, and to assess various
risk factors for complications. Methods: A retrospective analysis of a
computerized patient directory of 562 children admitted to the emergency
department (ED) in a tertiary pediatric hospital during a 10-year period
(Jan 2010-Dec 2019), with a witnessed NFB upon physical examination.
Results: Upon admittance to the ED, most of the children (82%) were
asymptomatic. Among the symptomatic children (18%), the primary
symptoms were nasal discharge (10%), epistaxis (8%) and pain (4%).
Younger children (under age 4 years) were more likely to insert organic
materials, compared to older children. Younger children were also
admitted sooner to the ED and were more likely to present with nasal
discharge. The overall complication rate was 5%. None of the children
had aspirated the NFB. Complications included infection (2%), necrosis
(0.7%), septal perforation (0.5%), deep mucosal laceration (1.5%) and
loss of NFB (1.9%). Significantly higher rates of symptoms and
complications were associated with button batteries. Increased risk for
complications were observed according to NFB-type, multiple attempts to
remove NFB, posterior insertion of NFB and left-side insertion.
Conclusions: NFB in children are common. Mostly, patients are
asymptomatic, therefore a high index of suspicion is required, for quick
diagnosis and safe removal, without complications.