Background
floor of the nose just below the inferior
A nasal foreign body is a condition
where something gets stuck in the nose.
This may include food, small toys, beads,
disk batteries, insects, worms, or pieces of
broken bones and cartilage. Maggots are
also considered as foreign body. Nasal
foreign bodies may get trapped in any part
of the nasal cavity. The patient may have
trouble in breathing if the object is very
deep in the nasal cavity.1,2
Foreign body in nasal cavity is the
most frequent case in emergency unit. It
can be experienced by children or adult
with mental disorder.3 Nasal foreign bodies
are common problem in children, most
frequently occurring between the ages of 2
and 5 years.3
According to Cetinkaya E, et all,
there were adequate data in the charts for
analysis. Among 623,000 children seen at
ENT Services of Antalya Ataturk State
Hospital and Izmir Tepecik Training
Research Hospital during the 8-year period
of study, 1870 children had nasal foreign
bodies There were 989 (52.9%) boys and
881(47.1%) girls.8
Nasal foreign bodies can be found in
any portion of the nasal cavity, although
they are typically discovered around the
turbinate. Another common location is
immediately anterior to the middle
turbinate.5
Foreign body in nasal cavity can be
devided into 2 part, that is organic such as
leech, maggot,and anorganic such as beads,
gravels, tissue, and metal.4
Button batteries may result in severe
destruction of the nasal septum. These are
composed of various types of heavy
metals: mercury, zinc, silver, nickel,
cadmium, and lithium. Liberation of these
substances causes various types of lesions
depending on the localisation, with an
intense local tissue reaction and
liquefaction necrosis. As a result they can
cause septal perforations, synechiae,
constriction, and stenosis of the nasal
cavity.5
Nasal foreign bodies may also cause
itching, pain, headache, and frequent
sneezing. Blood or a thick, yellowish fluid
may drain from the affected nostril. If the
foreign body is alive, such as insects or
worms, patient may feel movement in their
nose. Rare symptoms have been reported,
including bromidrosis (foul body odor) and
infections.6
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 ex-
traction 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.7
Case Report
Two years old girl came to the
emergency department of Sardjito Hospital
with a chief complaint a corn kernels in the
right nose about 2 hour before entering the
hospital, the child was playing with corn
kernels,and her parents see if her daughter
put in her nose and decided to bring her to
hospital. Nose obstruction (-), serous
discharge (+), blood (-). The patient had no
fever. Ear and throat complaints were
denied. On physical examination found
that the general condition was good,
compos mentis, pulse 100x/ minute,
respiratory rate 26x/minute, temperature
36,5 Celcius degree. On rhinoscopy
anterior right nose there was a yellow
coloured foreign body in the upper of
inferior turbinate, hyperemic inferior
turbinate (+), serous discharge (+),
epistaxis (-), nose septum intact and there
was no deviation. Examination of the left
nose shows there is no bleeding, discharge
(-), no hyperemic turbinate, septum intact
and deviation (-). Rhinoscopy posterior
was hard to evaluate. The examination of
oropharynx and ear within normal limits.
Based on the anamnesis and
physical examination the patient was
diagnosed with nasal foreign body in the
right nose. The issue with this case is
management. A round and slippery foreign
body can be a challenge to evacuate.
Evacuation was done with nasal spoon
hook and it succeeded. Control to the ENT
clinic if there was a sequel complaint. The
parents must to educated the child do not
play small objects without parental nasal orifice has, at one time or the other,
supervision. been removed.5

Discussion Sometimes diagnosis is too difficult.

To the unsuspecting karena anak tidak bisa
Nasal foreign bodies are common
komunikasi untuk memberi tau
problem in children, most frequently
orangtuanya, a unilateral suppurative or
occurring between the ages of 2 and 5
mucopurulent fetid nasal discharge may
years, because ketidak tahuan mereka
suggest a number of possibilities other than
tanpa sengaja memasukkan suatu benda
a foreign body.10
kedalam hidung. Maka oleh sebab itu bila
kita jumpai suatu kasus corpal hidung pada Pemeriksaan menggunakan
anak-anak, selain kita lakukan evakuasi endoskopi rigid dapat memvisualisasikan
pengambilan corpal kita juga harus lebih jelas benda asing dan mencegah
mengingatkan orang tua pasien. Agar trauma pada mukosa. CT scan mungkin
jangan sembarangan menaruh benda dan berguna untuk menentukan ukuran dan
membiarkan anaknya main tanpa tempat benda asing
pengawasan.9 usually beans or grains, as
Repeated attempts at nasal foreign
occurs with other common edible seeds,
body removal are likely to be successively
fall on the kitchen floor during cooking
more difficult, and the object may become
8
and are found by the children.
more deeply lodged. Therefore, careful
The objects can be found in any area planning is important to maximize the
of the nasal cavity, though they are most likelihood of removal on the first attempt.
predictably below the inferior turbinate,
Having the necessary instruments at
due toinferior turbinate extension, or
the bedside is essential, as is the clinician’s
immediately anterior to the middle
knowledge of several techniques. In
turbinate.8 These objects are generally
addition, emergency airway supplies
placed by children or mentally retarded
should be readily available in the event that
patients whose curiosity leads them to
manipulation of the foreign body results in
explore body orifices. Any article small
aspiration. Pharmacological
enough to be admitted into the anterior
vasoconstriction of the nasal mucosa can
facilitate both examination and removal of with a nasal spoon hook and there was no
an nasal foreign body.10 complication during and after the
evacuation.
Dengan bantuan kait buntu yang
diselipkan di belakang benda tersebut atau Reference
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