Сторонні тіла в носі

Nasal foreign bodies are found occasionally in young children, patients with intellectual impairment, and patients with psychiatric conditions. Common objects pushed into the nose include cotton, paper, pebbles, beads, beans, seeds, nuts, insects, magnets, and button batteries (which may cause chemical burns). When mineral salts are deposited on a long-retained foreign body, the object hardens and is called a rhinolith.

A nasal foreign body is suspected in any patient with a unilateral, foul-smelling, bloody, purulent rhinorrhea. Diagnosis is often made through another person’s observation of the item being pushed into the nose or through visualization with a nasal speculum.

Nasal foreign bodies should warrant prompt and careful removal to prevent complications such as infection, nasal perforation, and epistaxis. This is particularly critical for button batteries, which require emergent removal. Nasal foreign bodies can sometimes be removed in the office with a nasal speculum and Hartmann nasal forceps (see How To Do Nose Procedures). Wire loop or hook curettes, suction catheters or balloon catheters have also been used with success (1). Pretreatment with topical anesthetic and vasoconstrictors (lidocaine/epinephrine) may aid visualization and removal. To avoid pushing a slippery, round object deeper, it is better to reach behind the object with the bent tip of a blunt probe and pull it forward. Sometimes, general anesthesia is necessary if a rhinolith has formed or if the foreign body may be displaced dorsally and then aspirated, resulting in airway obstruction.

After removal, the nasal cavity should be inspected for any residual foreign material. Saline irrigation can help clear any debris and reduce the risk of infection. Antibiotics are typically not indicated following removal of a foreign body.