Intranasal foreign bodies: A 10-year analysis of a large cohort, in a tertiary medical center

Abstract

Objective: To describe the occurrence, clinical presentation and\nmanagement, of pediatric nasal foreign bodies, and to assess various\nrisk factors for complications. Methods: A retrospective analysis of a\ncomputerized patient directory of 562 children admitted to the emergency\ndepartment (ED) in a tertiary pediatric hospital during a 10-year period\n(Jan 2010-Dec 2019), with a witnessed NFB upon physical examination.\nResults: Upon admittance to the ED, most of the children (82%) were\nasymptomatic. Among the symptomatic children (18%), the primary\nsymptoms were nasal discharge (10%), epistaxis (8%) and pain (4%).\nYounger children (under age 4 years) were more likely to insert organic\nmaterials, compared to older children. Younger children were also\nadmitted sooner to the ED and were more likely to present with nasal\ndischarge. The overall complication rate was 5%. None of the children\nhad aspirated the NFB. Complications included infection (2%), necrosis\n(0.7%), septal perforation (0.5%), deep mucosal laceration (1.5%) and\nloss of NFB (1.9%). Significantly higher rates of symptoms and\ncomplications were associated with button batteries. Increased risk for\ncomplications were observed according to NFB-type, multiple attempts to\nremove NFB, posterior insertion of NFB and left-side insertion.\nConclusions: NFB in children are common. Mostly, patients are\nasymptomatic, therefore a high index of suspicion is required, for quick\ndiagnosis and safe removal, without complications.